Sultana, Aqfa

Sultana, Aqfa is an individual health care provider with primary practice located at 3502 W Northside Dr , Jackson MS 39213-4454. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Adult Medicine. Allopathic & Osteopathic Physicians / Adult Medicine is her primary health care specialty. Sultana, Aqfa can be contacted via phone (601) 364-5142.

Contact Information

Primary practice address
3502 W Northside Dr Jackson MS 39213-4454
Phone: (601) 364-5142
Fax: (601) 364-5159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 21234 Mississippi

Profile Details

NPI number 1700076940
LBN Legal business name Sultana, Aqfa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2007
Last updated Sep 23rd, 2020 - about 6 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 1700076940 NPPES
Mississippi MEDICAID 07331261
Mississippi MEDICAID 09964

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