Gusa, William Earl

Gusa, William Earl is an individual health care provider with primary practice located at 2500 North State Street , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Gusa, William Earl can be contacted via phone (601) 815-1196.

Contact Information

Primary practice address
2500 North State Street Jackson MS 39216-4500
Phone: (601) 815-1196
Fax: (601) 984-5939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X MD052249L Pennsylvania
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 24076 Mississippi

Profile Details

NPI number 1083614317
LBN Legal business name Gusa, William Earl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Apr 26th, 2016 - about 10 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 1083614317 NPPES
Pennsylvania MEDICAID 0014801510003
Pennsylvania Other P01620200

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