Provider Demographics
NPI:1255108643
Name:ARMSTRONG, JAMIE DOUGLAS
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DOUGLAS
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CAMERON RD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8221
Mailing Address - Country:US
Mailing Address - Phone:601-447-3721
Mailing Address - Fax:
Practice Address - Street 1:203 CAMERON RD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-8221
Practice Address - Country:US
Practice Address - Phone:601-447-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS801786201343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)