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JACKSON PSYCHIATRY GROUP NPI 1790087393


NPI Information

NPI: 1790087393
Provider Name: JACKSON PSYCHIATRY GROUP
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
1855 LAKELAND DR
SUITE P121
JACKSON, MS
ZIP 39216
Phone: (601) 366-4696
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JACKSON PSYCHIATRY GROUP 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has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. JACKSON PSYCHIATRY GROUP NPI is 1790087393. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1855 LAKELAND DR
SUITE P121
JACKSON, MS
ZIP 39216-913
Phone: (601) 366-4696
Fax: (866) 772-1223

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

The enumeration date for this NPI number is 12/2/2010 and was last updated on 3/30/2011.


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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