MEDICARE: AJAZ LLC

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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1558224188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJAZ LLC

Provider Business Mailing Address
First Line	:	600 RUE DAUPHINE
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 RUE DAUPHINE
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3048
Country	:	US
Telephone Number	:	228-327-0706
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ADAM JUSTICE
Credential	:
Telephone Number	:	228-327-0706

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “AJAZ LLC ” Practice Location

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