Deloach, Jim Alfred
Deloach, Jim Alfred is an sole proprietor health care provider with primary practice located at 330B Highway 90 , Gautier MS 39553-5744. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Deloach, Jim Alfred can be contacted via phone (228) 497-0434.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1205554656 |
|---|---|
| LBN Legal business name | Deloach, Jim Alfred |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2022 |
| Last updated | Aug 19th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205554656 | NPPES |
| Mississippi | MEDICAID | 00018214 |
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