Individual
TAYLOR DEUSHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
3814 OLD CANTON RD, JACKSON, MS 39216-3521
(949) 633-1921
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-4372
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2021
Last updated
07/02/2021
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