NPI 1124815352 · live from the CMS NPI Registry
Emmanuel Delase Agbeti, M.D
Family Medicine in Jackson, MS. National Provider Identifier 1124815352, active.
NPI record
| NPI | 1124815352 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 2500 North State Street, Jackson, MS 39216 |
| Practice phone | 601-984-5426 |
| Enumerated | April 22, 2025 |
| Last updated | August 14, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Family Medicine primary | 207Q00000X | T-5939 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.