| Mississippi Baptist Medical Center Railroad Medicare | |
|
1225 N State St Jackson MS 39202-2064 | |
| (601) 968-1362 | |
| (601) 292-4592 |
| Full Name | Mississippi Baptist Medical Center Railroad Medicare |
|---|---|
| Speciality | Psychologist |
| Location | 1225 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/ CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Baptist Medical Center Railroad Medicare 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: () - | Mississippi Baptist Medical Center Railroad Medicare 1225 N State St Jackson MS 39202-2064 Ph: (601) 968-1362 |
| NPI Number | 1124155809 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124155809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | (* (Not Available)) | Secondary |
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