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Individual

DR. JENS FRANCIS GRAVERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1002 JEFFERSON ST., SUITE 450, LAUREL, MS 39440-4306
(601) 428-0438
(601) 425-5553
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 399-6167
(601) 399-6281

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17542
MS
208800000X
Urology Physician
MD200326
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04274856
MS
05
1598551
LA
Enumeration date
03/15/2007
Last updated
01/06/2020
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