Individual
JACOB CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2497 N WEST ST, JACKSON, MS 39216-4409
(901) 246-4458
Mailing address
2497 N WEST ST, JACKSON, MS 39216-4409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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