Individual
DOUGLAS A WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF CARDIOLOGY, JACKSON, MS 39216
(601) 984-5678
(601) 984-5638
Mailing address
2500 N STATE ST, DEPT OF MEDICINE/DIVISION OF CARDIOLOGY, JACKSON, MS 39216-4500
(601) 984-5678
(601) 984-5638
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
15113
MS
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
16113
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117309
—
MS
Enumeration date
07/19/2006
Last updated
12/28/2015
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