Graves, Marilyn Davidson
Graves, Marilyn Davidson is an sole proprietor health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Graves, Marilyn Davidson can be contacted via phone (601) 815-7554.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 815-7554
Fax: (601) 815-3226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 05990 | Mississippi |
Profile Details
| NPI number | 1316149040 |
|---|---|
| LBN Legal business name | Graves, Marilyn Davidson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316149040 | NPPES |
| Mississippi | MEDICAID | 0014881 |
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