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General NPI Number Information
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NPI Number | 1225667249
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Entity Type | Individual
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Provider Name | MALLORY BROWNING
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Gender | Female
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 09/10/2022
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Provider Practice Location Address
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Address Line | 2500 NORTH STATE STREET
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City | JACKSON
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State | MS
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Zip | 39216-4505
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Country | US
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Telephone | 601-984-5582
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Fax |
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Provider Business Mailing Address
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Address Line | 6018 ROSEMEAD CIR
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City | BOSSIER CITY
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State | LA
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Zip | 71111-5675
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Country | US
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Telephone | 318-455-3550
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | T-4085
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License Number State | MS
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