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1720661440
COLTON FERNSTRUM
JACKSON, MS
NPI
1720661440
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: MS T-4271)
Enumeration Date
2021-04-30
Last Update Date
2021-07-01
Business Address
COLTON FERNSTRUM
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-4124
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Mailing Address
COLTON FERNSTRUM
1315 ROBERT DR
JACKSON, MS 39211-6337
Phone number:
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