Open Air of Mslou LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

OPEN AIR OF MSLOU LLC

Practice address

54 Seargent Prentiss Dr S
Suite 100
Natchez, MS 39120

Phone

(601) 442-2585

Fax

(601) 442-6299

NPI assigned

Jul 15, 2005

Last updated

Feb 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick G Howard

Title

Managing Member

Phone

(337) 291-9161

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1497754030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SEARGENT PRENTISS DR S",
            "address_2": "SUITE 100",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-442-2585",
            "fax_number": "601-442-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SEARGENT PRENTISS DR S",
            "address_2": "SUITE 100",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-442-2585",
            "fax_number": "601-442-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN AIR OF MSLOU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-291-9161"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442208",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124853",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Natchez, MS
• Providers in Natchez, MS by specialty
• Physiological Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.