Organization
UNIVERSITY EMERGENCY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA DEFORD ANDERSON M.D. (PHYSICIAN)
(601) 984-2538
Entity
Organization
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
(601) 815-1854
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16045
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122742
—
MS
Enumeration date
06/08/2006
Last updated
08/22/2020
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