Individual
DR. CHAD WAYNE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-5733
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-5733
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
2012006604
MO
207T00000X
Neurological Surgery Physician
Primary
23739
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04954267
—
MS
05
—
184168
—
MS
01
—
P01653140
RAILROAD MEDICARE PTAN
MS
Enumeration date
08/01/2007
Last updated
06/29/2016
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