Individual
MARION R. WOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/HYPERTENSION, JACKSON, MS 39216-4500
(601) 984-6525
(601) 984-6853
Mailing address
2500 N STATE ST, GENERAL INTERNAL MEDICINE-HYPERTENSION, JACKSON, MS 39216-4500
(601) 984-6525
(601) 984-6853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13910
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116903
—
MS
05
—
1053341
—
LA
01
—
P00462361
RAILROAD MEDICARE PTAN
MS
01
—
P1271440
RAILROAD MEDICARE
MS
Enumeration date
07/11/2006
Last updated
09/02/2016
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