Defatta, Jason

Defatta, Jason is an individual health care provider with primary practice located at 1800 12Th St , Meridian MS 39301-4158. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Defatta, Jason can be contacted via phone (601) 484-6700.

Contact Information

Primary practice address
1800 12Th St Meridian MS 39301-4158
Phone: (601) 484-6700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgery 208600000X 02086755 Mississippi

Profile Details

NPI number 1518382472
LBN Legal business name Defatta, Jason
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2014
Last updated Aug 4th, 2020 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1518382472 NPPES
Mississippi MEDICAID 02086755

Popular Providers