Individual
DR. GEORGE ELLIS ABRAHAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DIVISION OF PULMONARY, CRITICAL CARE, AND SLEEP MED, JACKSON, MS 39216-4500
(601) 984-5650
(601) 984-5658
Mailing address
2500 N STATE ST, DEPT OF PULMONARY, JACKSON, MS 39216-4500
(601) 984-5650
(601) 984-5658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19213
MS
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
19213
MS
207RP1001X
Pulmonary Disease Physician
Primary
19213
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04021333
—
MS
05
—
2359606
—
LA
Enumeration date
10/04/2006
Last updated
05/27/2014
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