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General NPI Number Information
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NPI Number | 1023115334
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Entity Type | Individual
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Provider Name | DINESH KUMAR GOEL M.D.P.A.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 6050 I-55 NORTH EAST FRONTAGE ROAD
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City | JACKSON
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State | MS
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Zip | 39211
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Country | US
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Telephone | 601-957-5150
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Fax | 601-957-5161
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Provider Business Mailing Address
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Address Line | PO BOX 16594
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City | JACKSON
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State | MS
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Zip | 39236-6594
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Country | US
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Telephone | 601-957-5150
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Fax | 601-957-5161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 640599749
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License Number State | MS
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