NPI 1518382472

Jason Defatta, DO

Practitioner Surgery Physician Meridian, MS

Practice location

Address: 1800 12th St, Meridian, MS 39301-4158
Phone: (601) 484-6700
Mailing address: PO Box 5183, Meridian, MS 39302-5183

Registered specialties (2)

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 02086755 (MS)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1518382472
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Feb 2014
Record last updated: 4 Aug 2020

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.