Individual
EDWARD PAUL LANDRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5200
Mailing address
504 CLINTON CENTER DRIVE, CBO - SUITE 4300, CLINTON, MS 39056-5610
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
25979
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02078311
—
MS
Enumeration date
03/23/2015
Last updated
06/01/2022
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