Beissel, Canon Jade

Beissel, Canon Jade is an individual health care provider with primary practice located at 35 W Monroe St , Grenada MS 38901-5222. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Beissel, Canon Jade can be contacted via phone (662) 226-8229.

Contact Information

Primary practice address
35 W Monroe St Grenada MS 38901-5222
Phone: (662) 226-8229
Fax: (662) 226-3300
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 16518 Mississippi

Profile Details

NPI number 1154483394
LBN Legal business name Beissel, Canon Jade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154483394 NPPES
Mississippi MEDICAID 06050013

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