Healthcare Provider Details

I. General information

NPI: 1558422196
Provider Name (Legal Business Name): ANN MYERS, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR SUITE 1157
JACKSON MS
39216-4643
US

IV. Provider business mailing address

971 LAKELAND DR SUITE 1157
JACKSON MS
39216-4643
US

V. Phone/Fax

Practice location:
  • Phone: 601-362-6900
  • Fax: 601-362-6111
Mailing address:
  • Phone: 601-362-6900
  • Fax: 601-362-6111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. (CLARA) 'ANN' MYERS
Title or Position: OWNER
Credential: MD
Phone: 601-362-6900