DR. IZZEDDIN KAMELMAZ (NPI# 1346344421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346344421 |
| Entity Type | Individual |
| Full Name | DR. IZZEDDIN KAMELMAZ |
| Credential | MD |
| Practice Address |
2100 Highway 61 N Vicksburg MS 39183-8211 |
| Mailing Address |
360 Simpson Hwy 149 Suite 250 Magee MS 39111-3842 |
| Practice Telephone | 6018836001 |
| Mailing Telephone | 6018491550 |
| Mailing Fax Number | 6018491551 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 22462 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS | 051092816 | 01 |
| AL | 000092816 | 05 | |
| MS | MS LICENSE | 20947 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 360 Simpson Hwy 149, Suite 250, Magee, MS 391113842 | 6018491550 | 6018491551 |
| Street Address |
2100 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357691 | Tulio Figarola | Orthopaedic Surgery | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2005-06-22 |
| 1639799430 | Vicksburg Healthcare LLC | Clinical Medical Laboratory | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-04-21 |
| 1407481880 | Casey Elaine Collier | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2020-03-06 |
| 1124682570 | Kpc Promise Hospital of Vicksburg LLC | Long Term Care Hospital | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-04-30 |
| 1144789801 | Laura Lavee Burris | Physician Assistant | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2019-03-12 |
| 1134699192 | Lisa Wamsley | Pharmacist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-12-03 |
| 1619456621 | Kimberly Washington | Physical Therapist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2018-08-09 |
| 1114459070 | Thulasi Ram Gudi | Internal Medicine | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-03-30 |
| 1518403617 | Brett Myers Scruggs | Nurse Anesthetist, Certified Registered | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2017-01-12 |
| 1770933731 | Cesar Luis Merino | Hospitalist | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689038630 | Lauren Dean Mckinney | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-04-06 |
| 1184655060 | Thomas C Moore | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-06 |
| 1831127422 | Gordon W Sluis | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180 | 2006-06-30 |
| 1841228087 | Deborah Smith | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-28 |
| 1639115173 | Elizabeth N Roy | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-22 |
| 1700821931 | Geri L Weiland | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-19 |
| 1033154794 | Lisa D Fairchild | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464181 | Meredith Sanford | Pediatrics | 101 Farm View Dr, Oxford, MS 38655-7728 | 2020-10-15 |
| 1255947297 | Gluckstadt Tc Kids, LLC | Pediatrics | 101 Lexington Dr Ste A, Madison, MS 39110-6986 | 2020-09-16 |
| 1982224895 | Vpa PC | Pediatrics | 111 E Capitol St Ste 215, Jackson, MS 39201-2108 | 2020-04-21 |
| 1992356166 | Marcie P Errington | Pediatrics | 3110 Sumrall Rd, Crystal Springs, MS 39059-8955 | 2019-09-27 |
| 1235635566 | North Mississippi Medcial Center, Inc. | Pediatrics | 1150 S Green St Ste D, Tupelo, MS 38804-4901 | 2018-04-04 |
| 1538675798 | The Pedz Clinic | Pediatrics | 610 3rd St Sw, Magee, MS 39111-3994 | 2017-12-22 |
| 1841715539 | Happicare One LLC Ppec Pediatric Daycare | Pediatrics | 213 W Park Ave, Greenwood, MS 38930-3008 | 2017-08-03 |
| 1336598028 | Andrea Logan Md | Pediatrics | 3631 Bienville Blvd Ste B, Ocean Springs, MS 39564-5702 | 2016-06-03 |
| 1730541640 | Stephanie Harrell | Pediatrics | 309 Llewellyn Ave, Mccomb, MS 39648-2703 | 2016-03-22 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
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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.