Provider Demographics
NPI:1154584811
Name:SANDHU, JASMINE (MD)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8597
Mailing Address - Country:US
Mailing Address - Phone:601-519-1101
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE ST STE 180
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2027
Practice Address - Country:US
Practice Address - Phone:601-414-0484
Practice Address - Fax:601-500-5060
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS724-L208000000X
MS21576208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics