Mallette, Robert A

Mallette, Robert A is an individual health care provider with primary practice located at 1200 N State St Ste 330 , Jackson MS 39202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mallette, Robert A can be contacted via phone (601) 353-2020.

Contact Information

Primary practice address
1200 N State St Ste 330 Jackson MS 39202
Phone: (601) 353-2020
Fax: (601) 714-5110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 09632 Mississippi

Profile Details

NPI number 1205831914
LBN Legal business name Mallette, Robert A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Mar 18th, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205831914 NPPES
Mississippi MEDICAID 1381951
Mississippi MEDICAID 1381951
Mississippi MEDICAID 529921670
Mississippi MEDICAID 009976305

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