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NPI Code Detail

MEDICARE: CHRISTINA L DIAL D.O.

MEDICARE:   CHRISTINA L DIAL  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician18187MS
22086X0206XSurgical Oncology Physician18187MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801989439
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA L DIAL D.O.
Provider Business Mailing Address
First Line : PO BOX 1066
Second Line :
City : RIDGELAND
State : MS
Zip : 39158-1066
Country : US
Telephone Number : 601-813-8133
Fax Number : 601-936-0088
Provider Business Practice Location Address
First Line : 230 TRACE COLONY
Second Line :
City : RIDGELAND
State : MS
Zip : 39157-8810
Country : US
Telephone Number : 601-936-8999
Fax Number : 601-936-0088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/10/2019

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Directions to “ CHRISTINA L DIAL D.O.” Practice Location

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