Healthcare Provider Details

I. General information

NPI: 1942612015
Provider Name (Legal Business Name): EMERGENCY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 RIDGEWOOD RD SUITE 100
JACKSON MS
39216-4921
US

IV. Provider business mailing address

PO BOX 55622
JACKSON MS
39296-5622
US

V. Phone/Fax

Practice location:
  • Phone: 601-936-6001
  • Fax: 601-936-4389
Mailing address:
  • Phone: 601-936-6001
  • Fax: 601-936-4389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC J ZOOG
Title or Position: SOLE MEMBER
Credential: MD
Phone: 601-936-6001