Individual provider · Type 1 NPI

Kentrell Marie Liddell, MD

Family Medicine Physician · Jackson, MS

NPI number 1659384063 Active

Practice location

2104 Thousand Oaks Dr
Jackson, MS 39212-2048

Call (601) 346-7450 Map

Fax (601) 346-7451

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000X17997 (MS)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1659384063

Kentrell Marie Liddell, MD's National Provider Identifier is 1659384063, issued on Aug 15, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Jackson, MS. The record was last updated on Sep 29, 2026.