Individual
DR. BERNARD G. DE ASIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117 SOUTH 11TH AVENUE, LAUREL, MS 39440
(601) 425-3033
(601) 422-0431
Mailing address
P.O. BOX 4361, LAUREL, MS 39441-4361
(601) 425-3033
(601) 422-0431
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
017249
MS
208000000X
Pediatrics Physician
Primary
17249
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124990
—
MS
Enumeration date
06/27/2005
Last updated
01/06/2016
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