National Provider Identifier Database

VICKSBURG ALLERGY AND ASTHMA
Allergy & Immunology

An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.


Contact Information

VICKSBURG ALLERGY AND ASTHMA
104 MCAULEY DR
VICKSBURG, MS39183-2825
Phone: 601-636-0097
Fax: 601-629-9969
Website:
Specialty Taxonomy Code
* Allergy & Immunology 207K00000X

* Indicates primary specialty

NPI Profile & details for VICKSBURG ALLERGY AND ASTHMA

NPI Number 1619140399
Legal business name
LBN
VICKSBURG ALLERGY AND ASTHMA
Authorized official TIMOTHY KERUT - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/02/2008
Last updated 04/02/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: 11047

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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