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General NPI Number Information
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NPI Number | 1366459026
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Entity Type | Individual
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Provider Name | CHEMENE QUINN MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 501 MARSHALL ST STE 406 DERMATOLOGY CONSULTANTS, PLLC
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City | JACKSON
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State | MS
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Zip | 39202-1650
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Country | US
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Telephone | 601-968-1912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3135 DERMATOLOGY CONSULTANTS, PLLC
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City | RIDGELAND
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State | MS
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Zip | 39158-3135
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Country | US
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Telephone | 601-968-1912
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A63958
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 18070
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License Number State | MS
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