Provider Demographics
NPI:1922338946
Name:GOMEZ SANCHEZ, ELISE P (DVM, PHD)
Entity Type:Individual
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First Name:ELISE
Middle Name:P
Last Name:GOMEZ SANCHEZ
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Gender:F
Credentials:DVM, PHD
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Mailing Address - Street 1:1500 E WOODROW WILSON AVE
Mailing Address - Street 2:151
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-5116
Mailing Address - Country:US
Mailing Address - Phone:601-368-3844
Mailing Address - Fax:601-364-1236
Practice Address - Street 1:1500 E WOODROW WILSON AVE
Practice Address - Street 2:151
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5116
Practice Address - Country:US
Practice Address - Phone:601-368-3844
Practice Address - Fax:601-364-1236
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS1381174MM1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174MM1900XOther Service ProvidersVeterinarianMedical Research