Provider Demographics
NPI:1427209733
Name:JEANETTE ZURAWSKI, M.D. PA
Entity Type:Organization
Organization Name:JEANETTE ZURAWSKI, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-680-6475
Mailing Address - Street 1:637 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-3732
Mailing Address - Country:US
Mailing Address - Phone:662-680-6475
Mailing Address - Fax:662-680-8607
Practice Address - Street 1:637 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-3732
Practice Address - Country:US
Practice Address - Phone:662-680-6475
Practice Address - Fax:662-680-8607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12070208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04837767Medicaid
MS390561728OtherBLUE CROSS/BLUE SHIELD
MSE09046Medicare UPIN
MS04837767Medicaid