Individual
DR. ALBERT W DREISBACH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF NEPHROLOGY, JACKSON, MS 39216
(601) 984-5687
Mailing address
2500 N STATE ST, DEPT OF MEDICINE DIVISION OF NEPHROLOGY, JACKSON, MS 39216-4500
(601) 984-5687
(601) 984-5765
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
19442
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123182
—
MS
05
—
116796
—
AL
05
—
1487872
—
LA
05
—
156408
—
AL
Enumeration date
06/26/2006
Last updated
03/07/2014
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