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NPI Code Detail

MEDICARE: JPA PATHOLOGY, P.A.

MEDICARE: JPA PATHOLOGY, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CG8291OTHERMSMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104824309
Entity Type Code : Organization
Provider Name (Legal Business Name) : JPA PATHOLOGY, P.A.
Provider Business Mailing Address
First Line : PO BOX 55873
Second Line :
City : JACKSON
State : MS
Zip : 39296-5873
Country : US
Telephone Number : 601-362-1319
Fax Number : 601-362-9569
Provider Business Practice Location Address
First Line : 969 LAKELAND DR
Second Line :
City : JACKSON
State : MS
Zip : 39216-4606
Country : US
Telephone Number : 601-200-6757
Fax Number : 601-200-8801
Authorized Official
Title or Position : ADMINISTRATOR
Name : JAMES P ALMAS
Credential : M.D.
Telephone Number : 601-200-6757
Provider Enumeration Date : 07/12/2005
Last Update Date : 07/21/2022

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1225002165 — DIANA MINASIAN STULC M.D.
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1851357925 — REGENCY HOSPITAL OF JACKSON, LLC
Practice Location Address:
969 LAKELAND DR , 6TH FLOOR
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Practice Fax:

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