Individual
DR. LOUIS JULIAN WISE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 OLD CANTON ROAD, SUITE 430, JACKSON, MS 39216
(601) 982-5441
(601) 982-5442
Mailing address
3000 OLD CANTON ROAD, SUITE 430, JACKSON, MS 39216
(601) 982-5441
(601) 982-5442
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
003970
MS
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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