PREMISE HEALTH OF MISSISSIPPI MEDICAL PC is a general practice in Ecru, MS. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PREMISE HEALTH OF MISSISSIPPI MEDICAL PC NPI is 1194140368. The provider is registered as an organization entity type and is a multi-specialty group. The provider Is Doing Business As Ashley Wellness Center.
The provider's business location address is:
305 HIGHWAY 346 ECRU, MS ZIP 38841-772 Phone: (662) 489-2669 Fax: (662) 489-2670
The provider's authorized official is Jonathan Leizman . The authorized official title is President and has the following contact phone number (216) 479-9063.
The CLIA number assigned to this NPI record is 25D2300550 - practitioner other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/25/2014 and was last updated on 10/13/2022.
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:
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: 3/30/2025
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.
