NPI 1497126775

Damon Bagley-Ayres, CPO

Practitioner Prosthetist Jackson, MS

Practice location

Address: 777 Lakeland Dr, Jackson, MS 39216-4611
Phone: (601) 815-4844
Fax: (601) 815-4592

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1497126775
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Oct 2015
Record last updated: 9 Jun 2016

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.