Individual
DR. ASHRAF TABATABAII
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
421 RIVER RD, PICAYUNE, MS 39466-3160
(601) 798-0511
Mailing address
421 RIVER RD, PICAYUNE, MS 39466-3160
(601) 798-0511
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
016970
LA
208000000X
Pediatrics Physician
Primary
10074
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019568
—
MS
05
—
1354180
—
LA
01
—
25D0319246
CLIA
MS
Enumeration date
10/30/2008
Last updated
10/30/2008
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