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NPI Code Detail

MEDICARE: MISS WHITNEY FAULCONER D.O.

MEDICARE: MISS WHITNEY FAULCONER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianT-2668MS
2207P00000XEmergency Medicine PhysicianR2329TX

General Provider Information

NPI Number : 1073953337
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS WHITNEY FAULCONER D.O.
Provider Business Mailing Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-984-5582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2013
Last Update Date : 03/16/2026

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1700734258 — SHAKYRA NASH
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1699798306 — DR. JOSEPH A OLIVER M.D.
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Directions to “ MISS WHITNEY FAULCONER D.O.” Practice Location

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