GREATER JACKSON PHYSICIAN GROUP NPI 1487067328

NPI Information

GREATER JACKSON PHYSICIAN GROUP is an obstetrics gynecology in Jackson, MS. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. GREATER JACKSON PHYSICIAN GROUP NPI is 1487067328. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Greater Jackson Physician Group, Llc.

The provider's business location address is:

501 MARSHALL ST STE 501
JACKSON, MS
ZIP 39202-615
Phone: (601) 968-0985
Fax: (601) 960-0583

The provider's authorized official is Linda M Swilley .
The authorized official title is Owner and has the following contact phone number (601) 968-0985.

The CLIA number assigned to this NPI record is 25D2095958 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2014 and was last updated on 7/21/2016.

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:

Other Identifiers

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