Deshazo, Richard D
Deshazo, Richard D is an individual health care provider with primary practice located at 878 Lakeland Dr Lb-Building, Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Deshazo, Richard D can be contacted via phone (601) 815-1078.Contact Information
Primary practice address
878 Lakeland Dr Lb-Building
Jackson MS 39216-4500
Phone: (601) 815-1078
Fax: (601) 984-6994
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207RA0201X | 15660 | Mississippi |
Profile Details
| NPI number | 1225072838 |
|---|---|
| LBN Legal business name | Deshazo, Richard D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Sep 25th, 2015 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225072838 | NPPES |
| Mississippi | MEDICAID | 0019701 |
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