Basic Information
Provider Information
NPI: 1295120673
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMOR FERRAND
FirstName: ALEJANDRO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 N STATE ST
Address2:  
City: JACKSON
State: MS
PostalCode: 392164500
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2500 N STATE ST
Address2:  
City: JACKSON
State: MS
PostalCode: 392164500
CountryCode: US
TelephoneNumber: 2125237321
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/01/2015
LastUpdateDate: 02/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RI0011X29645MSY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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