Individual
MR. MARSHALL ADAMS BRISCOE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 RIVER OAKS DR, JACKSON, MS 39232-9553
(601) 376-2832
(601) 376-1816
Mailing address
PO BOX 321359, FLOWOOD, MS 39232-1359
(601) 936-1395
(601) 933-6596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25804
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06029871
—
MS
01
—
687536
INTERNAL MEDICINE
MS
Enumeration date
04/24/2015
Last updated
09/20/2021
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