Individual
AHMED TAYEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5102
(601) 984-5110
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5102
(601) 984-5110
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02302395
—
MS
Enumeration date
07/07/2015
Last updated
10/26/2015
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