Individual
JUSTIN ALAN QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 985-5532
Mailing address
312 W LAWSON ST, CLINTON, MS 39056-4116
(601) 917-8952
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22402
MS
208000000X
Pediatrics Physician
22402
MS
Other
Enumeration date
07/02/2010
Last updated
03/25/2024
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