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EAST LAKELAND OB GYN ASSOCIATES P.A. NPI 1235220112

NPI Profile

NPI: 1235220112
Provider Name: EAST LAKELAND OB GYN ASSOCIATES, P.A.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
1020 RIVER OAKS DR
SUITE 320
JACKSON, MS
ZIP 39232
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Phone: (601) 936-1400

EAST LAKELAND OB GYN ASSOCIATES, P.A. is a healthcare provider in Jackson, MS.The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. EAST LAKELAND OB GYN ASSOCIATES, P.A. NPI is 1235220112. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1020 RIVER OAKS DR
SUITE 320
JACKSON, MS
ZIP 39232-500
Phone: (601) 936-1400
Fax: (601) 936-0671

The provider's authorized official is Beverly Ann Mcmillan .
The authorized official title is President and has the following contact phone number (601) 936-1400.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 5/27/2008.

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
1207V00000XObstetrics & GynecologyYes

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
1=========OTHERMISSISSIPPITAX ID NUMBER
2C00927MEDICARE PINMISSISSIPPI
39013604MEDICAIDMISSISSIPPI

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: 9/8/2019

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