|
| |
|
971 Lakeland Dr Suite 557 Jackson MS 39216-4643 | |
| (601) 200-4560 | |
| (601) 200-4850 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 971 Lakeland Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Danielle Stuart (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6012004880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 23666 Jackson MS 39225-3666 Ph: (601) 200-4560 | 971 Lakeland Dr Suite 557 Jackson MS 39216-4643 Ph: (601) 200-4560 |
| NPI Number | 1215350152 |
|---|---|
| Provider Enumeration Date | 01/29/2014 |
| Last Update Date | 10/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215350152 | NPI | - | NPPES |
| 07430597 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 21151 (Mississippi) | Primary |
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 | |
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 | |