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1467147850
OLIVER DIAZ GOMEZ
JACKSON, MS
NPI
1467147850
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS T-5115)
Enumeration Date
2023-04-10
Last Update Date
2023-07-01
Business Address
OLIVER DIAZ GOMEZ MD
764 LAKELAND DR
JACKSON, MS 39216-4651
Phone number: 601-984-6800
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Mailing Address
OLIVER DIAZ GOMEZ MD
1204 GREYMONT AVE
JACKSON, MS 39202-2155
Phone number: 407-968-1080
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