Individual
GERRY ANN HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 TOWNE CENTER BLVD, RIDGELAND, MS 39157-4804
(601) 898-1053
Mailing address
450 TOWNE CENTER BLVD, RIDGELAND, MS 39157-4804
(601) 898-1053
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
08360
MS
207RH0003X
Hematology & Oncology Physician
08360
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115432
—
MS
05
—
1967343
—
LA
01
—
4223312
AETNA HEALTHCARE
—
Enumeration date
06/10/2005
Last updated
02/12/2015
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