OrganizationActive
Mississippi Asthma & Allergy Clinic PA
NPI 1902882251 · Allergy & Immunology Physician · Jackson, MS
Provider details
- NPI number
- 1902882251
- Entity type
- Organization
- Primary specialty
- Allergy & Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Moak, Practice Administrator(601) 354-4836
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1513 Lakeland Dr
Ste 100
Jackson, MS 39216-4829
Phone: (601) 354-4836
Fax: (601) 354-2619
Approximate (ZIP-level) locationGet directions
Mailing address
1513 Lakeland Dr
Jackson, MS 39216-4829
Registry dates
- Enumerated
- 2005-12-19
- Last updated
- 2010-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.