Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 00027421 | AL |
Y | 2080P0204X | Pediatric Emergency Doctor | 20662 | MS |
NPI | 1306880661 |
---|---|
Provider Name | Dr. Melissa N Frascogna |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 02/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009937983 | (05) | AL |
051535676 | BCBS PROVIDER NUMBER (01) | AL |
157459 | (05) | AL |
I57164 | (02) | AL |