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General NPI Number Information
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NPI Number | 1184183725
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Entity Type | Individual
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Provider Name | MARY ARNETTA SANGSTER
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 1850 CHADWICK DR
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City | JACKSON
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State | MS
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Zip | 39204-3404
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Country | US
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Telephone | 601-376-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 200 FAWN CIR
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City | BRANDON
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State | MS
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Zip | 39047-6369
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Country | US
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Telephone | 601-720-7449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246X00000X
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Taxonomy Name | Cardiovascular Specialist/Technologist
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License Number |
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License Number State | MS
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