Healthcare Provider Details

I. General information

NPI: 1457679300
Provider Name (Legal Business Name): JENNIFER LASHAY ATKINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LASHAY RUMPH M.D.

II. Dates (important events)

Enumeration Date: 05/16/2010
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 RATLIFF ST
LUCEDALE MS
39452-6537
US

IV. Provider business mailing address

PO BOX 1007
LUCEDALE MS
39452-1007
US

V. Phone/Fax

Practice location:
  • Phone: 601-947-8181
  • Fax:
Mailing address:
  • Phone: 601-947-1330
  • Fax: 601-947-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number070420
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number32527
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25924
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: