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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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MS 3514-09
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location