IndividualActive
Damon Bagley-Ayres, CPO
NPI 1497126775 · Prosthetist · Jackson, MS
Provider details
- NPI number
- 1497126775
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CPO
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Orthotist222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
777 Lakeland Dr
Jackson, MS 39216-4611
Phone: (601) 815-4844
Fax: (601) 815-4592
Approximate (ZIP-level) locationGet directions
Mailing address
777 Lakeland Dr
Jackson, MS 39216-4611
Registry dates
- Enumerated
- 2015-10-13
- Last updated
- 2016-06-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.