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PMT CLINIC NPI 1629378971


NPI Information

NPI: 1629378971
Provider Name: PMT CLINIC

Other Name: PSYCHIATRIC MEDICINE AND THERAPY

Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
1855 LAKELAND DR
SUITE P101
JACKSON, MS
ZIP 39216
Phone: (601) 366-4696
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PMT CLINIC is a prescribing (medical) psychologist in Jackson, MS. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. PMT CLINIC NPI is 1629378971. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Psychiatric Medicine And Therapy.

The provider's business location address is:

1855 LAKELAND DR
SUITE P101
JACKSON, MS
ZIP 39216-913
Phone: (601) 366-4696
Fax: (601) 366-6574

The provider's authorized official is Doug W Byrd .
The authorized official title is Owner and has the following contact phone number (601) 366-4696.

The enumeration date for this NPI number is 11/2/2010 and was last updated on 11/2/2010.


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
1103TP0016XPsychologistPrescribing (Medical)15999MISSISSIPPIYes

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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