Individual
ASHLEY VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5532
Mailing address
1418 GREYMONT AVE, APT B, JACKSON, MS 39202-1803
(601) 819-0738
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28780
MS
208000000X
Pediatrics Physician
28780
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2017
Last updated
09/15/2021
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