NPI 1790158293

Jbchiro1 LLC

Organisation Preferred Provider Organization Diberville, MS

Practice location

Address: 11516 Lamey Bridge Rd Suite E, Diberville, MS 39540-2725
Phone: (228) 207-6427
Fax: (228) 207-6428

Authorised official

Name: John Bamban
Title: Owner
Phone: (228) 207-6427

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1179 (MS)

Other Preferred Provider Organization providers in Mississippi →

Registry record

NPI: 1790158293
Entity type: Organization
NPI issued: 5 Nov 2015
Record last updated: 5 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.