Jimenez Agosto, Jaime
Jimenez Agosto, Jaime is an individual health care provider with primary practice located at 1420 S 28Th Ave , Hattiesburg MS 39402-3107. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Uveitis and Ocular Inflammatory Disease. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Jimenez Agosto, Jaime can be contacted via phone (601) 264-3937.Contact Information
Primary practice address
1420 S 28Th Ave
Hattiesburg MS 39402-3107
Phone: (601) 264-3937
Fax: (601) 264-5930
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 12372 | Mississippi |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | H8698 | Texas |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 12372 | Mississippi |
| Allopathic & Osteopathic Physicians / Uveitis and Ocular Inflammatory Disease | 207WX0108X | 12372 | Mississippi |
Profile Details
| NPI number | 1932102951 |
|---|---|
| LBN Legal business name | Jimenez Agosto, Jaime |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Apr 5th, 2017 - about 7 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 | 1932102951 | NPPES |
| Mississippi | Other | 512I180024 | MEDICARE PTAN FOR SOUTHERN EYE PHYSICIAN'S CENTER LLC |
| Mississippi | MEDICAID | 00115830 | MEDICARE PTAN FOR SOUTHERN EYE PHYSICIAN'S CENTER LLC |
| Mississippi | Other | 512I180025 | MEDICARE PTAN FOR SOUTHERN EYE PHYSICIAN'S CENTER LLC |
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