Healthcare Provider Details

I. General information

NPI: 1588016455
Provider Name (Legal Business Name): YOUSAF ZAFAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

504 CLINTON CENTER DRIVE CBO - SUITE 4300
CLINTON MS
39056
US

V. Phone/Fax

Practice location:
  • Phone: 601-815-2005
  • Fax:
Mailing address:
  • Phone: 601-815-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number27775
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: