Healthcare Provider Details

I. General information

NPI: 1588582266
Provider Name (Legal Business Name): JACORY CURB SR. QMHP-CS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 STILES ST
CLARKSDALE MS
38614-3612
US

IV. Provider business mailing address

924 STILES ST
CLARKSDALE MS
38614-3612
US

V. Phone/Fax

Practice location:
  • Phone: 469-836-6487
  • Fax:
Mailing address:
  • Phone: 469-836-6487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: