JACKSON FREE CLINIC NPI 1851068324

NPI Information

  • NPI: 1851068324
  • Provider Name: JACKSON FREE CLINIC
  • Classification: Voluntary or Charitable - 251V00000X
  • Entity Type: Organization
  • Former Legal Business Name: JACKSON FREE CLINIC FOR THE HOMELESS
  • CLIA Number: 25D0995019
  • Address: 925 MARTIN LUTHER KING JR DR
    JACKSON, MS
    ZIP 39203
  • Phone: (601) 355-5161

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NPI Details

JACKSON FREE CLINIC is a voluntary or charitable in Jackson, MS. JACKSON FREE CLINIC NPI is 1851068324. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Jackson Free Clinic For The Homeless.

The provider's business location address is:

925 MARTIN LUTHER KING JR DR
JACKSON, MS
ZIP 39203-233
Phone: (601) 355-5161

The provider's authorized official is Hali Peterson .
The authorized official title is Chair Of The Board and has the following contact phone number (601) 355-5161.

The CLIA number assigned to this NPI record is 25D0995019 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/24/2021 and was last updated on 6/21/2022.

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
1251V00000XVoluntary or CharitableYes

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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