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Individual

DEBORAH VIRGINIA GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1200 N STATE ST STE 450, JACKSON, MS 39202-2000
(601) 957-7343
Mailing address
1000 URBAN CENTER DR STE 600, VESTAVIA, AL 35242-2584
(205) 208-9312
(208) 848-2227

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
14099
MS
2084P0800X
Psychiatry Physician
14099
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00114296
MS
05
009987395
AL
05
611212800
MS
Enumeration date
08/16/2006
Last updated
01/12/2024
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