Individual
DR. JUDY GEARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
878 LAKELAND DR, JACKSON, MS 39216-4644
(601) 984-6800
(601) 984-6811
Mailing address
PO BOX 4999, JACKSON, MS 39296-4999
(601) 984-6800
(601) 984-6811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09122
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112688
—
MS
01
—
P00641631
RR MEDICARE
MS
Enumeration date
10/05/2006
Last updated
02/13/2014
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