Provider Demographics
NPI:1497580203
Name:KISSOON, NIGEL RAMESH (PUBLIC HEALTH DOCTOR)
Entity type:Individual
Prefix:DR
First Name:NIGEL
Middle Name:RAMESH
Last Name:KISSOON
Suffix:
Gender:M
Credentials:PUBLIC HEALTH DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FECHET DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2508
Mailing Address - Country:US
Mailing Address - Phone:718-710-6717
Mailing Address - Fax:
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:
Practice Address - City:KEESLER AFB
Practice Address - State:MS
Practice Address - Zip Code:39534-2508
Practice Address - Country:US
Practice Address - Phone:228-376-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS40287171000000X, 174H00000X, 171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty