| Four Corners Psychiatry Pllc | |
|
1225 N State St Jackson MS 39202-2064 | |
| (601) 968-1031 | |
| (601) 292-4520 |
| Full Name | Four Corners Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1225 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Jared Kerome Taylor (SOLE MBR) |
| Authorized Official Contact | 6019469372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Psychiatry Pllc 1888 Main St Ste C Madison MS 39110-6337 Ph: (601) 946-9372 | Four Corners Psychiatry Pllc 1225 N State St Jackson MS 39202-2064 Ph: (601) 968-1031 |
| NPI Number | 1790477636 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 05/22/2023 |
| Certification Date | 05/20/2023 |
| Medicare PECOS PAC ID | 7012375132 |
|---|---|
| Medicare Enrollment ID | O20230622001402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790477636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | Santrise Goree |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770760357 PECOS PAC ID: 1456524305 Enrollment ID: I20111109000540 |
| Provider Name | Jared K Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154686541 PECOS PAC ID: 1355657305 Enrollment ID: I20170405002281 |
Miracle Care Home Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5120 Galaxie Dr, Suite-b, Jackson, MS 39206 Phone: 601-982-1909 Fax: 601-982-8177 | |
Chandler & Associates Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1900 Dunbarton Dr Ste J, Jackson, MS 39216 Phone: 769-428-1681 Fax: 769-241-5091 | |
Gifted Futures Ms Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6040 I-55 North Frontage Rd., Jackson, MS 39211 Phone: 929-466-1305 | |
1st Priority Healthcare Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 River Ridge Dr, Suite 102, Jackson, MS 39216 Phone: 252-315-5165 Fax: 888-376-1118 | |
Guided Steps Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Dunbarton Dr, Suite I, Jackson, MS 39216 Phone: 504-491-0774 Fax: 336-464-2227 | |
Marion Counseling Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Briarwood Dr Ste 510, Jackson, MS 39206 Phone: 601-956-4816 Fax: 601-956-4816 | |
Ridgewood Clinics Pa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1059 Ridgewood Clinic, Jackson, MS 39211 Phone: 601-957-3211 Fax: 601-957-9753 |