Individual
JUDITH M. DIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/DIVISION OF INFECTIOUS DISEASE, JACKSON, MS 39216-4500
(601) 984-5560
(601) 984-5565
Mailing address
2500 NORTH STATE STREET, DIVISION OF INFECTIOUS DISEASE, JACKSON, MS 39216-4500
(601) 984-5560
(601) 984-5565
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
R113920
MS
363L00000X
Nurse Practitioner
Primary
R113920
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04054008
—
MS
05
—
1522813
—
LA
Enumeration date
07/10/2006
Last updated
03/01/2016
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