Individual
DR. SRIVALLI GANNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, DEPT OF PSYCHIATRY AND BEHAVIOR, JACKSON, MS 39216-4500
(601) 815-4725
Mailing address
2500 N STATE ST, UMMC DEPT OF PSYCHIATRY AND BEHAVIOR, JACKSON, MS 39216-4500
(601) 815-4725
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
755L
MS
390200000X
Student in an Organized Health Care Education/Training Program
229921
MA
Other
Enumeration date
09/18/2008
Last updated
08/20/2009
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