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Provider Information for 1831322288



DR. JOHN WILLEY MEASELLS JR. DMD

Gender: MALE

Individual NPI: 1831322288

Calendar Last Updated: 2016-12-01

Details

Name Value
NPI 1831322288
Enumeration Date 2009-09-02
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1909 MISSION 66
VICKSBURG, MS 39180-3711
United States

Phone: 601-638-9111 | Fax: 601-638-0013
View Map External Link
Primary Practice Address 1909 MISSION 66
VICKSBURG, MS 39180-3711
United States

Phone: 601-638-9111 | Fax: 601-638-0013
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MS 3514-09