Sultana, Aqfa
Sultana, Aqfa is an individual health care provider with primary practice located at 3502 W Northside Dr , Jackson MS 39213-4454. She 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 / Adult Medicine. Allopathic & Osteopathic Physicians / Adult Medicine is her primary health care specialty. Sultana, Aqfa can be contacted via phone (601) 364-5142.Contact Information
Primary practice address
3502 W Northside Dr
Jackson MS 39213-4454
Phone: (601) 364-5142
Fax: (601) 364-5159
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 21234 | Mississippi |
Profile Details
NPI number | 1700076940 |
---|---|
LBN Legal business name | Sultana, Aqfa |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 25th, 2007 |
Last updated | Sep 23rd, 2020 - about 4 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 | 1700076940 | NPPES |
Mississippi | MEDICAID | 07331261 | |
Mississippi | MEDICAID | 09964 |
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