Individual
DR. JOSHUA RUSSELL MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8988
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8988
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
13510
MS
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
23183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09037308
—
MS
05
—
T73578
—
SC
Enumeration date
02/20/2006
Last updated
11/03/2015
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