Doctor Name: | STEVEN WILSON CABELL |
NPI Number: | 1083662100 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | R857889 |
Business Practice Address: | 427 Highway 51 N Brookhaven, MS - 396012350 |
Business Phone Number: | 8008939698 |
Business Fax Number: | |
Mailing Address: | 4230 Summerton Dr, JACKSON |
State: | MS |
Postal Code: | 392728738 |
Phone Number: | 8008939698 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 11/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R857889 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |