Individual
COLTON FERNSTRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-4124
Mailing address
1315 ROBERT DR, JACKSON, MS 39211-6337
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
T-4271
MS
Other
Enumeration date
04/30/2021
Last updated
07/01/2021
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