| Premier Choice Healthcare And Educational Services | |
|
1832 Hospital Dr Jackson MS 39204-3410 | |
| (214) 620-4927 | |
| Not Available |
| Full Name | Premier Choice Healthcare And Educational Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1832 Hospital Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Christopher Alan Carson (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 2146205860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Choice Healthcare And Educational Services Po Box 820472 Vicksburg MS 39182-0472 Ph: (214) 620-4927 | Premier Choice Healthcare And Educational Services 1832 Hospital Dr Jackson MS 39204-3410 Ph: (214) 620-4927 |
| NPI Number | 1437503513 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 04/14/2016 |
| Medicare PECOS PAC ID | 4587955588 |
|---|---|
| Medicare Enrollment ID | O20160622001673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437503513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 880514 (Mississippi) | Primary |
| Provider Name | Christopher A Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578986915 PECOS PAC ID: 8426376559 Enrollment ID: I20160708000108 |
| Provider Name | Kimberly Shatwone Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174052773 PECOS PAC ID: 7810288818 Enrollment ID: I20170727002711 |
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