Organization
DERMATOPATHOLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUU T DUONG MD (MEMBER)
(601) 362-9851
Entity
Organization
Contact information
Practice address
3120 OLD CANTON RD, JACKSON, MS 39216
(601) 362-9851
(601) 982-9025
Mailing address
PO BOX 3528, JACKSON, MS 39207-3528
(601) 362-9851
(601) 982-9025
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
25D0688888
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120024
—
MS
05
—
009931780
—
AL
05
—
135488709
—
AR
05
—
1964310
—
LA
01
—
690008330
RAILROAD MEDICARE
—
Enumeration date
07/08/2006
Last updated
08/29/2024
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