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General NPI Number Information
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NPI Number | 1396771044
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Entity Type | Individual
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Provider Name | BIMAL DEEP AUJLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 3550 HIGHWAY 468 W
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City | PEARL
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State | MS
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Zip | 39208-5529
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Country | US
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Telephone | 601-351-8000
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Fax | 601-351-8301
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Provider Business Mailing Address
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Address Line | PO BOX 157A
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City | WHITFIELD
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State | MS
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Zip | 39193-0157
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Country | US
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Telephone | 601-351-8000
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Fax | 601-351-8301
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C158567
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 16683
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License Number State | MS
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