Healthcare Provider Details

I. General information

NPI: 1467381210
Provider Name (Legal Business Name): ASMAA MOUSSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MISSISSIPPI MEDICAL CENTER DEPARTMENT OF PATHOLOGY, 2500 NORTH STATE STREET
JACKSON MS
39216
US

IV. Provider business mailing address

UNIVERSITY OF MISSISSIPPI MEDICAL CENTER DEPARTMENT OF PATHOLOGY, 2500 NORTH STATE STREET
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 601-815-2741
  • Fax:
Mailing address:
  • Phone: 601-815-2741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberT6290
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: