Organization
ANAZIA MEDICAL II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR O ANAZIA D.O. (CEO)
(601) 249-0013
Entity
Organization
Contact information
Practice address
1264 MAIN STREET, SUITE A, FAYETTE, MS 39069
(601) 786-0390
(601) 786-0730
Mailing address
120 5TH AVENUE, MCCOMB, MS 39648
(601) 249-0013
(601) 249-0592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14997
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07753329
—
MS
Enumeration date
09/08/2006
Last updated
10/29/2010
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