Individual
GABRIELLE FACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5338
(601) 815-4112
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5338
(601) 815-4112
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1427235076
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02200834
—
MS
Enumeration date
06/25/2015
Last updated
09/17/2015
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