# THE AKESO GROUP - VICKSBURG

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE AKESO GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366746588
- **Legal business name:** THE AKESO GROUP
- **Authorized official:** DR. JOHNATHAN MILTON ISOM M.D. (CEO)
- **Authorized official phone:** (901) 797-9711

## Contact information

- **Practice address:** 2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
- **Practice address phone:** (601) 883-5000
- **Mailing address:** 5744 NANJACK CIR, MEMPHIS, TN 38115-2061
- **Mailing address phone:** (901) 797-9711
- **Mailing address fax:** (901) 797-9771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 01/03/2011
- **Last updated:** 01/03/2011