NPI 1114409422

Julie Wyatt Dermatology Clinic, PLLC

Organisation Dermatology Physician Jackson, MS

Practice location

Address: 3000 Old Canton Rd STE 430, Jackson, MS 39216-4225
Phone: (601) 982-5441
Fax: (601) 982-5442

Authorised official

Name: Julie P Wyatt
Title: Owner
Phone: (601) 982-5441

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 20645 (MS)

Other Dermatology providers in Mississippi →

Registry record

NPI: 1114409422
Entity type: Organization
NPI issued: 4 Sep 2018
Record last updated: 4 Sep 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.