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
Fax: (601) 984-5783
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477621324 NPPES
Mississippi MEDICAID 08952891

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