Provider Demographics
NPI:1699891705
Name:TRIHOULIS, JENNIFER G (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:G
Last Name:TRIHOULIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5266 OLD HIGHWAY 11 STE 70-309
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-7817
Mailing Address - Country:US
Mailing Address - Phone:601-336-2220
Mailing Address - Fax:601-336-2221
Practice Address - Street 1:1113 HIGHWAY 98 BYP STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-3746
Practice Address - Country:US
Practice Address - Phone:601-336-2220
Practice Address - Fax:601-336-2221
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS196312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry