Individual
DR. IZZEDDIN KAMELMAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-6001
Mailing address
360 SIMPSON HWY 149, SUITE 250, MAGEE, MS 39111-3842
(601) 849-1550
(601) 849-1551
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22462
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000092816
—
AL
01
—
051092816
BCBS
AL
01
—
20947
MS LICENSE
MS
Enumeration date
09/11/2006
Last updated
09/11/2020
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