Organization Active NPI

Magnolia Allergy and Skin Care

  • Allergy & Immunology (Internal Medicine) Physician
  • Clinton, MS
National Provider Identifier
1225534530
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
22223 Issued in MS
Legal business name
MAGNOLIA ALLERGY AND SKIN CARE
Practice address
102 E Leake St
Clinton, MS 39056-4204
Phone
(601) 519-9562
NPI assigned
Apr 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lan Zhou, MD PHDNPI 1881953693
Title
Physician
Phone
(601) 519-9562

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RA0201X 22223 MS Primary

Addresses

Primary practice location

102 E Leake St
Clinton, MS 39056-4204

Mailing address

124 Heights Dr
Clinton, MS 39056-6602
Phone (601) 519-9562

Other names 1

  • Magnolia Allergy Clinic LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

402 Cynthia St
Ste E
Clinton, MS 39056
Phone (601) 460-1693

102 E Leake St
Clinton, MS 39056
Phone (601) 519-9562

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1225534530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 HEIGHTS DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390566602",
            "telephone_number": "601-519-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E LEAKE ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564204",
            "telephone_number": "601-519-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA ALLERGY AND SKIN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "ZHOU",
        "authorized_official_first_name": "LAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "601-519-9562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "MS",
            "license": "22223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Allergy Clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.