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1659384063
KENTRELL MARIE LIDDELL
JACKSON, MS
NPI
1659384063
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS 17997)
Enumeration Date
2006-08-15
Last Update Date
2013-04-09
Business Address
Dr. KENTRELL MARIE LIDDELL M.D.
2104 THOUSAND OAKS DR
JACKSON, MS 39212-2048
Phone number: 601-346-7450
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Mailing Address
Dr. KENTRELL MARIE LIDDELL M.D.
2104 THOUSAND OAKS DR
JACKSON, MS 39212-2048
Phone number: 601-346-7450
Copy
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