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1114318417
JEFFERSON BUNTIN
PICAYUNE, MS
NPI
1114318417
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: MS R881222)
Enumeration Date
2015-02-09
Last Update Date
2015-02-09
Business Address
JEFFERSON BUNTIN N.P.
146 HIGHLAND PKWY
PICAYUNE, MS 39466-5575
Phone number: 601-358-9765
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Mailing Address
JEFFERSON BUNTIN N.P.
146 HIGHLAND PKWY
PICAYUNE, MS 39466-5575
Phone number:
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