DR. FAUSTA DITAH (NPI# 1063675692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063675692 |
| Entity Type | Individual |
| Full Name | DR. FAUSTA DITAH |
| Practice Address |
700 W Forest Ave Ste 300 Jackson TN 38301-3937 |
| Mailing Address |
Po Box 400 Jackson TN 38302-0400 |
| Practice Telephone | 7314220305 |
| Practice Fax Number | 7314220357 |
| Mailing Telephone | 7314238697 |
| Mailing Fax Number | 7314255783 |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD50497 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
700 W FOREST AVE STE 300 |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881958 | Heath Broussard | Surgery | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2005-09-14 |
| 1659723823 | Jennifer S Mcfarland | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2016-07-12 |
| 1164767133 | Lisa Jewel Alexander Nwokolo | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2012-12-03 |
| 1487970497 | William Charles Barrow | Psychiatry & Neurology | 700 W Forest Ave, Ste 200, Jackson, TN 38301-3937 | 2010-04-15 |
| 1033448642 | Amanda Caroline Holley | Audiologist | 700 W Forest Ave, Ste. 300, Jackson, TN 38301-3937 | 2009-12-10 |
| 1275868390 | West Tennessee Medical Group Inc | Durable Medical Equipment & Medical Supplies | 700 W Forest Ave, Suite 200, Jackson, TN 38301-3937 | 2009-10-07 |
| 1689816142 | Timothy Philip Love | Surgery | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-03-30 |
| 1407092836 | Margaret J Spragins | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-01-07 |
| 1760653505 | Timothy Chad Davenport | Urology | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-03-20 |
| 1356528442 | Shahzad Shah | Internal Medicine | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902374085 | St. Dominic Medical Associates LLC | Internal Medicine | 970 Lakeland Dr Ste 43, Jackson, MS 39216-4634 | 2018-11-07 |
| 1740353515 | Deborah S. Skelton | Internal Medicine | 971 Lakeland Dr Ste 1160, Jackson, MS 39216-4609 | 2006-11-17 |
| 1679657860 | Shanti Siddiqui | Internal Medicine | 609 New York Ranch Rd, Jackson, CA 95642-9328 | 2006-10-24 |
| 1598708752 | Nadeem Ullah Md | Internal Medicine | 720 W Franklin, Suite 2, Jackson, MI 49201-1676 | 2006-06-14 |
| 1477525103 | Babu V Rao | Internal Medicine | 241 Stonebridge Blvd, Jackson, TN 38305-2179 | 2006-02-06 |
| 1447249354 | Gastrointestinal Endoscopy Center | Internal Medicine | 1405 N State St, Suite 300, Jackson, MS 39202-1642 | 2005-10-14 |
| 1649268822 | Billy W Long | Internal Medicine | 1421 N State St, Suite 203, Jackson, MS 39202-1658 | 2005-10-11 |
| 1700873056 | Allan M Menachem | Internal Medicine | 9 Physicians Dr, Jackson, TN 38305-2071 | 2005-10-03 |
| 1376549816 | John Joseph Sheehan Jr. | Internal Medicine | 2500 North State Street, Department of Medicine Division of Digestive Disease, Jackson, MS 39216-4500 | 2005-06-21 |
| 1326585522 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-25 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.