Healthcare Provider Details

I. General information

NPI: 1144541970
Provider Name (Legal Business Name): MEGAN LYNN WASHINGTON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 RIVER OAKS DR STE 100
FLOWOOD MS
39232-9500
US

IV. Provider business mailing address

1020 RIVER OAKS DR STE 100
FLOWOOD MS
39232-9500
US

V. Phone/Fax

Practice location:
  • Phone: 601-326-8700
  • Fax: 601-936-2252
Mailing address:
  • Phone: 601-326-8700
  • Fax: 601-936-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24585
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: