Provider Demographics
NPI:1831109024
Name:JEAN-PIERRE, CYNTHIA V (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:V
Last Name:JEAN-PIERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HIGHLAND PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-5577
Mailing Address - Country:US
Mailing Address - Phone:601-798-5798
Mailing Address - Fax:601-798-3964
Practice Address - Street 1:128 HIGHLAND PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-5577
Practice Address - Country:US
Practice Address - Phone:601-798-5798
Practice Address - Fax:601-798-3964
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19428207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03428890Medicaid
LA1050717Medicaid
MSP00634449OtherRAILROAD MEDICARE
MSP00634449OtherRAILROAD MEDICARE