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NPI Verification

National Provider Identifier: 1306632344

Modupe Harriet Ajisafe, M.d

Individual Provider

Credentials

M.D

Primary Specialty

Family Medicine

Code: 207Q00000X

Practice Address

DEPARTMENT OF FAMILY MEDICINE

2500 N STATE ST

JACKSON, MS 39216

Phone: 601-984-5426

NPI Enumeration Date

April 16, 2025

NPI Number

1306632344

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry