Individual
DR. FELICIE G WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216
(601) 200-4644
(601) 200-4645
Mailing address
PO BOX 22727, JACKSON, MS 39225-2727
(601) 200-4644
(601) 200-4645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.30440
AL
207R00000X
Internal Medicine Physician
Primary
ME139323
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
21128
MS
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
22847
NE
Other
Enumeration date
10/13/2006
Last updated
05/10/2021
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