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JACKSON ONCOLOGY ASSOCIATESPLLC NPI 1346379500


NPI Information

NPI: 1346379500
Provider Name: JACKSON ONCOLOGY ASSOCIATES,PLLC
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 25D0965188

Address:
2969 CURRAN DR N STE 200
JACKSON, MS
ZIP 39216
Phone: (601) 974-5601
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JACKSON ONCOLOGY ASSOCIATES,PLLC is a hematology and oncology internal medicine in Jackson, MS. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. JACKSON ONCOLOGY ASSOCIATES,PLLC NPI is 1346379500. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2969 CURRAN DR N STE 200
JACKSON, MS
ZIP 39216-121
Phone: (601) 974-5601
Fax: (601) 974-5699

The provider's authorized official is Richard W Griffith .
The authorized official title is Executive Director and has the following contact phone number (601) 974-5578.

The CLIA number assigned to this NPI record is 25D0965188 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 11/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103330910MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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