Aultman, Virgil Isaac

Aultman, Virgil Isaac is an sole proprietor health care provider with primary practice located at 2747 Old Canton Rd , Jackson MS 39216-4308. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Aultman, Virgil Isaac can be contacted via phone (601) 366-6452.

Contact Information

Primary practice address
2747 Old Canton Rd Jackson MS 39216-4308
Fax: (601) 366-6488
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 06153 Mississippi

Profile Details

NPI number 1922006279
LBN Legal business name Aultman, Virgil Isaac
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2005
Last updated Mar 15th, 2010 - about 16 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 1922006279 NPPES
Mississippi MEDICAID 00013576

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