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Individual

DR. ADELE A THIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1020 RIVER OAKS DR, SUITE 420, FLOWOOD, MS 39232-9500
(601) 939-4198
(601) 939-4120
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5500
(601) 984-5503

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
12161
MS
2084N0400X
Neurology Physician
Primary
12161
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0114179
MS
05
09013832
MS
01
130010501
RAILROAD MEDICARE
MS
Enumeration date
08/20/2006
Last updated
10/15/2018
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