Centerwell Senior Primary Care-jackson East | |
1220 E Northside Dr Ste 220 Jackson MS 39211-5503 | |
(601) 298-4173 | |
(877) 866-2356 |
Full Name | Centerwell Senior Primary Care-jackson East |
---|---|
Speciality | Internal Medicine |
Location | 1220 E Northside Dr Ste 220, Jackson, Mississippi |
Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
Authorized Official Contact | 4074477120 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Centerwell Senior Primary Care-jackson East 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care-jackson East 1220 E Northside Dr Ste 220 Jackson MS 39211-5503 Ph: (601) 298-4173 |
NPI Number | 1710693619 |
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Provider Enumeration Date | 01/25/2023 |
Last Update Date | 07/03/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710693619 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208D00000X | General Practice | (* (Not Available)) | Secondary |
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