DR. JASON L POLK D. M. D NPI 1033131487

NPI Information

NPI: 1033131487
Provider Name: DR. JASON L POLK, D. M. D
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
120 SCARBROUGH ST
SUITE B
RICHLAND, MS
ZIP 39218
Phone: (601) 932-0606
Get Directions

DR. Jason L Polk, D. M. D is a general practice dentist in Richland, MS. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jason L Polk, D. M. D NPI is 1033131487. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

120 SCARBROUGH ST
SUITE B
RICHLAND, MS
ZIP 39218-770
Phone: (601) 932-0606
Fax: (601) 932-0703

The enumeration date for this NPI number is 7/24/2006 and was last updated on 7/9/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	3137	MISSISSIPPI	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	00660432	MEDICAID	MISSISSIPPI
2	00660433	MEDICAID	MISSISSIPPI
3	09016079	MEDICAID	MISSISSIPPI

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

NPI Synchronization or Removal

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