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1194089508
AJAY VONGALA
JACKSON, MS
NPI
1194089508
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS 23970)
Enumeration Date
2012-06-29
Last Update Date
2022-12-22
Business Address
AJAY VONGALA MD
1225 N STATE ST
JACKSON, MS 39202-2064
Phone number: 601-968-1000
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Mailing Address
AJAY VONGALA MD
1225 N STATE ST
JACKSON, MS 39202-2064
Phone number: 601-968-1000
Copy
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