Individual
ADAM GARY ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5650
(601) 984-5658
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
82535
SC
207RP1001X
Pulmonary Disease Physician
Primary
33403
MS
208M00000X
Hospitalist Physician
82535
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825352
—
SC
Enumeration date
06/03/2019
Last updated
07/02/2024
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