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MR. GEORGE WOODSON GULLY JR. LPN
NPI 1003579509
Licensed Practical Nurse in Jackson, MS

Active since October 21, 2021
1935 LAKELAND DR STE 900, JACKSON, MS 39216(601) 718-2468 Get Directions Write a Review

NPPES record last updated: October 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. George Woodson Gully Jr. Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GEORGE WOODSON GULLY JR. LPN (NPI 1003579509) is an individual licensed practical nurse in Jackson, Mississippi, licensed in Mississippi (338464) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1003579509
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. GEORGE WOODSON GULLY JR.Credential: LPN
Location Address1935 LAKELAND DR STE 900Jackson, MS 39216-5028
Mailing Address1935 Lakeland Dr Ste 900Jackson, MS 39216-5028 · (601) 718-2468
Phone(601) 718-2468
Sole ProprietorNo
Enumeration DateOctober 21, 2021
NPPES CertifiedOctober 21, 2021
✔ NPI 1003579509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MS · 338464
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
1935 LAKELAND DR STE 900, Jackson, MS 39216
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACKSON COMPREHENSION TREATMENT CENTER
Counselor (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
MS. DETRA LA'QUEL HUMPHRIES RN
Registered Nurse (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2487
DENESHA SPENCER
Licensed Practical Nurse
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
JASMINE ROBB
Counselor (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 366-7167
DR. WILLIAM WALTER JOHNSON M.D.
Preventive Medicine (Addiction Medicine)
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 840-1454
SHANEIKA PARKER LPN
Licensed Practical Nurse
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
WILLIAM NATHAN CRAVEN
Clinic/Center (Methadone)
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
ROY CHESTER HARNESS MSW,PCHMT,PCAT
Counselor (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2648

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is George Gully's NPI number?

The NPI number for George Gully is 1003579509. It was assigned to this individual provider in the NPPES registry on October 21, 2021.

Where is George Gully located?

George Gully practices at 1935 Lakeland Dr Ste 900, Jackson, MS 39216. The listed phone number is (601) 718-2468.

What is George Gully's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for George Gully was last updated on October 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.