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Individual

MRS. LAURA JANE CRECELIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3301 TININ DR, CORINTH, MS 38834-9054
(662) 665-9111
(662) 665-9118
Mailing address
3301 TININ DR, CORINTH, MS 38834-9054
(662) 665-9111
(662) 665-9118

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15036
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00117464
MS
Enumeration date
01/03/2006
Last updated
05/09/2013
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