PHILLIPS MEDICAL SERVICES PLLC NPI 1174792790

NPI Information

  • NPI: 1174792790
  • Provider Name: PHILLIPS MEDICAL SERVICES PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 25D0984523
  • Address: 909 ELLIS AVE STE 16
    JACKSON, MS
    ZIP 39209
  • Phone: (601) 948-8503

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NPI Details

PHILLIPS MEDICAL SERVICES PLLC is a family medicine in Jackson, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHILLIPS MEDICAL SERVICES PLLC NPI is 1174792790. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

909 ELLIS AVE STE 16
JACKSON, MS
ZIP 39209-256
Phone: (601) 948-8503
Fax: (601) 948-8502

The provider's authorized official is Tricia Duncan .
The authorized official title is Biller and has the following contact phone number (601) 878-6945.

The CLIA number assigned to this NPI record is 25D0984523 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2008 and was last updated on 4/30/2014.

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
1207Q00000XFamily Medicine10785MISSISSIPPIYes

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 Other Provider Identifier Issuer
100116024MEDICAIDMISSISSIPPI
2512G700212MEDICARE PINMISSISSIPPI

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: 11/21/2025

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