Granados, Javel

Granados, Javel is an individual health care provider with primary practice located at 7276 Southcrest Pkwy , Southaven MS 38671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Granados, Javel can be contacted via phone (662) 349-6577.

Contact Information

Primary practice address
7276 Southcrest Pkwy Southaven MS 38671
Fax: (662) 349-6562
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 16287 Mississippi

Profile Details

NPI number 1518074517
LBN Legal business name Granados, Javel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518074517 NPPES
Mississippi MEDICAID 00122207

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