Individual
RAYSHONN JAMYL BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
57 INDUSTRIAL PARK RD, LUCEDALE, MS 39452-6583
(601) 947-4274
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 327-5843
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
08/31/2020
Last updated
08/31/2020
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