De Asis, Bernard G.

De Asis, Bernard G. is an individual health care provider with primary practice located at 117 South 11Th Avenue , Laurel MS 39440. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. De Asis, Bernard G. can be contacted via phone (601) 425-3033.

Contact Information

Primary practice address
117 South 11Th Avenue Laurel MS 39440
Phone: (601) 425-3033
Fax: (601) 422-0431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 017249 Mississippi
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 17249 Mississippi

Profile Details

NPI number 1275539017
LBN Legal business name De Asis, Bernard G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Jan 6th, 2016 - about 9 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 1275539017 NPPES
Mississippi MEDICAID 00124990

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