Jackson Thyroid & Endocrine Clinic Pllc | |
971 Lakeland Dr Suite 353 Jackson MS 39216-4643 | |
(601) 949-6990 | |
(601) 949-6105 |
Full Name | Jackson Thyroid & Endocrine Clinic Pllc |
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Speciality | Internal Medicine |
Location | 971 Lakeland Dr, Jackson, Mississippi |
Authorized Official Name and Position | John Woody Sistrunk (OWNER) |
Authorized Official Contact | 6019496990 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jackson Thyroid & Endocrine Clinic Pllc 971 Lakeland Dr Suite 353 Jackson MS 39216-4643 Ph: (601) 949-6990 | Jackson Thyroid & Endocrine Clinic Pllc 971 Lakeland Dr Suite 353 Jackson MS 39216-4643 Ph: (601) 949-6990 |
NPI Number | 1134671787 |
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Provider Enumeration Date | 10/31/2016 |
Last Update Date | 12/13/2019 |
Medicare PECOS PAC ID | 4284902289 |
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Medicare Enrollment ID | O20170615001849 |
Identifier | Type | State | Issuer |
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1134671787 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 15819 (Mississippi) | Primary |
Provider Name | John W Sistrunk |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1164430419 PECOS PAC ID: 0941293922 Enrollment ID: I20040406000471 |
Provider Name | Amanda K Boyanton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053369355 PECOS PAC ID: 0547299471 Enrollment ID: I20050810000831 |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |