| Mississippi Phs Pc | |
|
405 Briarwood Drive Suite 103 Jackson MS 39206-3029 | |
| (901) 261-4848 | |
| (901) 261-4849 |
| Full Name | Mississippi Phs Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 405 Briarwood Drive, Jackson, Mississippi |
| Authorized Official Name and Position | Nicole Howard (CFO) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Phs Pc 1509 Dulles Drive Lafayette LA 70506 Ph: (337) 991-9276 | Mississippi Phs Pc 405 Briarwood Drive Suite 103 Jackson MS 39206-3029 Ph: (901) 261-4848 |
| NPI Number | 1326278615 |
|---|---|
| Provider Enumeration Date | 07/21/2009 |
| Last Update Date | 07/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326278615 | NPI | - | NPPES |
| 00439060 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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