Individual
COURTNEY LOUISE VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
92 RATLIFF ST, LUCEDALE, MS 39452-6537
(601) 947-8181
(601) 947-4411
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 947-8181
(601) 947-4411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19722
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06584011
—
MS
01
—
P00659768
PALMETTO GBA MEDICARE
MS
Enumeration date
07/24/2007
Last updated
08/15/2011
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