NPI 1902882251

Mississippi Asthma & Allergy Clinic PA

Organisation Allergy & Immunology Physician Jackson, MS

Practice location

Address: 1513 Lakeland Dr STE 100, Jackson, MS 39216-4829
Phone: (601) 354-4836
Fax: (601) 354-2619
Mailing address: 1513 Lakeland Dr STE 101, Jackson, MS 39216-4829

Authorised official

Name: David L Moak
Title: Practice Administrator
Phone: (601) 354-4836

Registered specialties

Allergy & Immunology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207K00000X

Other Allergy & Immunology providers in Mississippi →

Registry record

NPI: 1902882251
Entity type: Organization
NPI issued: 19 Dec 2005
Record last updated: 16 Feb 2010

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.