Healthcare Provider Details

I. General information

NPI: 1184638033
Provider Name (Legal Business Name): AREMMIA D. TANIOUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S 13TH AVE
LAUREL MS
39440-4342
US

IV. Provider business mailing address

319 S 13TH AVE
LAUREL MS
39440-4342
US

V. Phone/Fax

Practice location:
  • Phone: 601-426-2140
  • Fax: 601-340-3220
Mailing address:
  • Phone: 601-426-2140
  • Fax: 601-340-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number15909
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number15909
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number15909
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: