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JACKSON THYROID & ENDOCRINE CLINIC PLLC NPI 1134671787


NPI Information

NPI: 1134671787
Provider Name: JACKSON THYROID & ENDOCRINE CLINIC PLLC
Classification: Internal Medicine - 207RE0101X
Entity Type: Organization

Specialization: Endocrinology, Diabetes & Metabolism

CLIA Number: 25D1064921

Address:
971 LAKELAND DR
SUITE 353
JACKSON, MS
ZIP 39216
Phone: (601) 949-6990
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JACKSON THYROID & ENDOCRINE CLINIC PLLC is an endocrinology and diabetes and metabolism internal medicine in Jackson, MS. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. JACKSON THYROID & ENDOCRINE CLINIC PLLC NPI is 1134671787. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

971 LAKELAND DR
SUITE 353
JACKSON, MS
ZIP 39216-643
Phone: (601) 949-6990
Fax: (601) 949-6105

The provider's authorized official is John Woody Sistrunk .
The authorized official title is Owner and has the following contact phone number (601) 949-6990.

The CLIA number assigned to this NPI record is 25D1064921 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/31/2016 and was last updated on 12/13/2019.


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
1207RE0101XInternal MedicineEndocrinology, Diabetes & Metabolism15819MISSISSIPPIYes

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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