Provider Demographics
NPI:1831286699
Name:HERRING, JOEL H (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:H
Last Name:HERRING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2001
Mailing Address - Country:US
Mailing Address - Phone:601-981-4091
Mailing Address - Fax:601-981-5039
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2001
Practice Address - Country:US
Practice Address - Phone:601-981-4091
Practice Address - Fax:601-981-5039
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2017-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS14956207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS180043047OtherRAILROAD MEDICARE
MS0124326Medicaid
MS0124326Medicaid
MSG96548Medicare UPIN