Individual
MICHAEL JAMES NOWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5232
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5232
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
16137
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120013
—
MS
05
—
1545911
—
LA
Enumeration date
06/17/2006
Last updated
06/21/2012
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