Basic Information
| Provider Information | |||||||||
| NPI: | 1740555952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZELIG | ||||||||
| FirstName: | ARI | ||||||||
| MiddleName: | YISRAEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2155 WEST ST | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381383856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016233323 | ||||||||
| FaxNumber: | 9016233324 | ||||||||
| Practice Location | |||||||||
| Address1: | 7676 AIRWAYS BLVD | ||||||||
| Address2: | |||||||||
| City: | SOUTHAVEN | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386715304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016233323 | ||||||||
| FaxNumber: | 9016233324 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2012 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | 63741 | TN | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 207KA0200X | 29167 | MS | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy |
No ID Information.