Mr. Glen Robert Graves
M.D. | Pediatric Neonatal-Perinatal Medicine | Male
Mr. Glen Robert Graves, M.D. is a Jackson, Mississippi based Pediatric doctor with medical specialization in
Pediatric Neonatal-Perinatal Medicine.
Current practice location of Mr. Glen Robert Graves is
2500 N State St, Jackson, Mississippi - 39216-4500. He can be contacted on phone at
601-815-7100.
Mr. Glen Robert Graves is a sole proprietor of his business.
NPI number (Unique professional ID) for Mr. Glen Robert Graves is
1407883234 which was assigned by NPPES on 27 Jun, 2006 and it was last updated on 27 Jun, 2012.
Mr. Glen Robert Graves license number is
05989 for Pediatrics Neonatal-Perinatal Medicine (2080N0001X) in Mississippi.
Mr. Glen Robert Graves is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Complete Profile:
Mr. Glen Robert Graves basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Neonatal-Perinatal Medicine |
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| Provider Name : | Mr. Glen Robert Graves |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Mr. Glen Robert Graves address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-815-7100 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1407883234 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 27 Jun, 2006 |
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| Last Updated On : | 27 Jun, 2012 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Glen Robert Graves are as mentioned. Primary taxonomy code for Mr. Glen Robert Graves, M.D. is
2080N0001X (Pediatrics Neonatal-Perinatal Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080N0001X | Pediatrics Neonatal-Perinatal Medicine | Yes | 05989 | MS |
Legacy Identifiers:
Other legacy medical identifiers of Mr. Glen Robert Graves such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 1969265 | MEDICAID | LA | |
| 00017226 | MEDICAID | MS | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-815-7100 |
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Business Location:
Patients can refer following map for directions to
Mr. Glen Robert Graves practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.