Velasco, Ignacio

Velasco, Ignacio is an sole proprietor health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Velasco, Ignacio can be contacted via phone (601) 984-6090.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-6090
Fax: (601) 984-4949
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 15341809-8 Zz
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X OS-538-17 Mississippi

Profile Details

NPI number 1780083311
LBN Legal business name Velasco, Ignacio
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2014
Last updated Jan 31st, 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 1780083311 NPPES
Mississippi MEDICAID 08437071

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