NPI 1548777428

Earl Buckhanan

Practitioner Community Health Worker Jackson, MS

Practice location

Address: 460 Briarwood Dr STE 510, Jackson, MS 39206-3057
Phone: (601) 956-4816
Fax: (601) 956-4817
Mailing address: PO Box 13509, Jackson, MS 39236-3509

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in Mississippi →

Registry record

NPI: 1548777428
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Jan 2018
Record last updated: 2 Jan 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.