MEDICAL MALL HEALTH SERVICES OF MISSISSIPPI LLC NPI 1194083139

NPI Information

NPI: 1194083139
Provider Name: MEDICAL MALL HEALTH SERVICES OF MISSISSIPPI, LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
350 W WOODROW WILSON AVE
SUITE 499A
JACKSON, MS
ZIP 39213
Phone: (601) 700-7709
Get Directions

MEDICAL MALL HEALTH SERVICES OF MISSISSIPPI, LLC is a primary care nurse practitioner in Jackson, MS. MEDICAL MALL HEALTH SERVICES OF MISSISSIPPI, LLC NPI is 1194083139. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

350 W WOODROW WILSON AVE
SUITE 499A
JACKSON, MS
ZIP 39213-681
Phone: (601) 700-7709
Fax: (877) 852-6352

The provider's authorized official is Timothy P Mcneil .
The authorized official title is Coo and has the following contact phone number (202) 344-5465.

The enumeration date for this NPI number is 4/27/2012 and was last updated on 3/12/2015.

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	363LP2300X	Nurse Practitioner	Primary Care			Yes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »