Basic Information
| Provider Information | |||||||||
| NPI: | 1518270164 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOUZA | ||||||||
| FirstName: | ANA LUIZA | ||||||||
| MiddleName: | LOVIAT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 NORTH STATE STREET | ||||||||
| Address2: | UNIVERSITY OF MISSISSIPPI MEDICAL CENTER | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392164505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019845200 | ||||||||
| FaxNumber: | 6019842086 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 NORTH STATE STREET | ||||||||
| Address2: | UNIVERSITY OF MISSISSIPPI MEDICAL CENTER | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392164505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019845200 | ||||||||
| FaxNumber: | 6019842086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2010 | ||||||||
| LastUpdateDate: | 07/23/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 788-L | MS | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.