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Individual

CAROLYN KUHN GLENDYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8489
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25726
MS
208000000X
Pediatrics Physician
T-2952
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
25726
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9936303
MS
Enumeration date
07/31/2012
Last updated
01/17/2022
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