Windham, Beverly Gwen
Windham, Beverly Gwen is an individual health care provider with primary practice located at 2500 North State Street Department Of Medicine Division Of Geriatrics, Jackson MS 39216. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Windham, Beverly Gwen can be contacted via phone (601) 984-5610.Contact Information
Primary practice address
2500 North State Street Department Of Medicine Division Of Geriatrics
Jackson MS 39216
Phone: (601) 984-5610
Fax: (601) 984-5783
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | D0056056 | Maryland |
Profile Details
| NPI number | 1477621324 |
|---|---|
| LBN Legal business name | Windham, Beverly Gwen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Apr 11th, 2014 - about 12 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 | 1477621324 | NPPES |
| Mississippi | MEDICAID | 08952891 |
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