Mississippi Asthma & Allergy Clinic PA
NPI #1902882251 in Jackson, Mississippi
Provider Information
- NPI Number
- 1902882251
- Entity Type
- Organization
- Organization Name
- Mississippi Asthma & Allergy Clinic PA
- Primary Specialty
- Allergy & Immunology
- Enumeration Date
- Dec 19, 2005
- Last Updated
- Feb 16, 2010
Practice Location
- Address
- 1513 LAKELAND DR
- Address 2
- STE 100
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-4829
- Phone
- (601) 354-4836
Authorized Official
- Name
- MR. DAVID L MOAK
- Title
- PRACTICE ADMINISTRATOR
- Phone
- (601) 354-4836
Specialties & Taxonomy Codes
| Specialty |
|---|
| Allergy & Immunology |
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