Individual
DR. GLORIA MANGUM PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
107 BRIDLEWOOD DR, BRANDON, MS 39047-8302
(601) 359-5155
(601) 359-5725
Mailing address
107 BRIDLEWOOD DR, BRANDON, MS 39047-8302
(601) 992-7168
(601) 992-2352
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12665
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017860
—
MS
Enumeration date
05/24/2007
Last updated
11/05/2015
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