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Individual

MR. JASON S. BOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 394-2820
(601) 394-2748
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 947-1332
(601) 947-1331

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R875627
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00027266
MS
Enumeration date
01/04/2007
Last updated
01/13/2011
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