Healthcare Provider Details

I. General information

NPI: 1881384030
Provider Name (Legal Business Name): MR. AMARDEEP SINGH SAGGI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

786 LAKELAND DRIVE 2ND FLOOR
JACKSON MS
39216
US

IV. Provider business mailing address

2500 NORTH STATE STREET
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-6800
  • Fax: 601-984-6811
Mailing address:
  • Phone: 347-296-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37601
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: