Organization
SLEEP CONSULTANTS DIAGNOSTIC LAB
Active
Other names
Sleep Consultants Sleep Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN F ROSE MD (OWNER)
(601) 982-7111
Entity
Organization
Contact information
Practice address
403 TOWNE CENTER BLVD, STE 101A, RIDGELAND, MS 39157-4843
(601) 982-7111
(601) 981-2524
Mailing address
403 TOWNE CENTER BLVD, STE 101A, RIDGELAND, MS 39157-4843
(601) 982-7111
(601) 981-2524
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
08416
MS
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
08416
MS
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010055
—
MS
01
—
302G708148
MEDICARE PTAN
MS
Enumeration date
06/05/2007
Last updated
08/27/2012
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