| Greater Jackson Physician Group, Llc | |
|
501 Marshall St Ste 501 Jackson MS 39202-1615 | |
| (601) 968-0985 | |
| (601) 960-0583 |
| Full Name | Greater Jackson Physician Group, Llc |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 501 Marshall St Ste 501, Jackson, Mississippi |
| Authorized Official Name and Position | Linda M Swilley (OWNER) |
| Authorized Official Contact | 6019680985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Jackson Physician Group, Llc 501 Marshall St Ste 501 Jackson MS 39202-1615 Ph: (601) 899-3990 | Greater Jackson Physician Group, Llc 501 Marshall St Ste 501 Jackson MS 39202-1615 Ph: (601) 968-0985 |
| NPI Number | 1487067328 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 07/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487067328 | NPI | - | NPPES |
| 06373834 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Primary |
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