Organization
BASTIAN CENTER OF PEDIATRIC ENDOCRINOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BASTIAN M.D. (PROVIDER/OWNER)
(601) 376-1545
Entity
Organization
Contact information
Practice address
1860 CHADWICK DR, SUITE 206, JACKSON, MS 39204-3463
(601) 376-1545
Mailing address
1860 CHADWICK DR, SUITE 206, JACKSON, MS 39204-3463
(601) 376-1545
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
19260
MS
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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