Grayson, Jennifer Leticia

Grayson, Jennifer Leticia is an sole proprietor health care provider with primary practice located at 147 Reynoir St Ste 202 , Biloxi MS 39530-4109. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Grayson, Jennifer Leticia can be contacted via phone (228) 594-8000.

Contact Information

Primary practice address
147 Reynoir St Ste 202 Biloxi MS 39530-4109
Phone: (228) 594-8000
Fax: (228) 594-8002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 17609 Mississippi

Profile Details

NPI number 1346357498
LBN Legal business name Grayson, Jennifer Leticia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Feb 19th, 2015 - about 11 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 1346357498 NPPES
Mississippi Other 680498058 BLUE CROSS/ BLUE SHIELD
Mississippi MEDICAID 00125565 BLUE CROSS/ BLUE SHIELD

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