Individual
JAGDISH DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7158
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(224) 430-3545
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301100126
MI
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
23724
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00882811
—
MS
Enumeration date
01/07/2013
Last updated
08/07/2015
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