Individual
LAURA ASHLEY TASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216
(601) 815-6960
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
MT209380
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2012
Last updated
07/11/2023
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