Organization
UNIVERSITY INTERNAL MEDICINE ASSOC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD DESHAZO MD (MANAGING PARTNER)
(601) 987-3988
Entity
Organization
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF MEDICINE, JACKSON, MS 39216-4500
(601) 984-5600
Mailing address
1867 CRANE RIDGE DR, STE 150-A UNIVERSITY INTERNAL MEDICINE ASSOCIATES, LLP, JACKSON, MS 39216-4982
(601) 987-3988
(601) 987-4165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MS
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09012352
—
MS
Enumeration date
06/13/2006
Last updated
07/21/2022
Update your record
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