| Capital City Endocrine Clinic Llc | |
|
4755 I 55 N Jackson MS 39206-5602 | |
| (601) 895-0000 | |
| (601) 895-0001 |
| Full Name | Capital City Endocrine Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4755 I 55 N, Jackson, Mississippi |
| Authorized Official Name and Position | Juliette Sandifer Kum-nji (OWNER) |
| Authorized Official Contact | 6018950000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital City Endocrine Clinic Llc 4755 I 55 N Jackson MS 39206 Ph: (601) 895-0000 | Capital City Endocrine Clinic Llc 4755 I 55 N Jackson MS 39206-5602 Ph: (601) 895-0000 |
| NPI Number | 1255084398 |
|---|---|
| Provider Enumeration Date | 01/29/2022 |
| Last Update Date | 06/08/2023 |
| Medicare PECOS PAC ID | 9234509670 |
|---|---|
| Medicare Enrollment ID | O20221230000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255084398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Juliette Laginger Sandifer Kum-nji |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1528385291 PECOS PAC ID: 3678841319 Enrollment ID: I20221230000090 |
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