Basic Information
| Provider Information | |||||||||
| NPI: | 1003006602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASAJPOUR | ||||||||
| FirstName: | HOSSEIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 247 | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394410247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014257522 | ||||||||
| FaxNumber: | 6014287841 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394404243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014257522 | ||||||||
| FaxNumber: | 6014287841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2007 | ||||||||
| LastUpdateDate: | 08/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 21406 | MS | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208600000X | MD200014 | LA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0122X | 21406 | MS | Y | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery |
No ID Information.