Provider Demographics
NPI:1841452661
Name:RESCH, ALLYN LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:ALLYN
Middle Name:LEIGH
Last Name:RESCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4412 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6038
Mailing Address - Country:US
Mailing Address - Phone:601-317-1608
Mailing Address - Fax:
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:318-966-4541
Practice Address - Fax:318-966-4543
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99102347A207RP1001X
MS21152207R00000X
MST-2073207R00000X
LA320976207RC0200X, 207RP1001X, 208M00000X
ORMD183692207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07550094Medicaid
AL178297Medicaid
MS07550094Medicaid