Healthcare Provider Details

I. General information

NPI: 1982810958
Provider Name (Legal Business Name): ARTHRITIS ASSOCIATES OF MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 N STATE ST STE 302
JACKSON MS
39202-2413
US

IV. Provider business mailing address

1190 N STATE ST STE 302
JACKSON MS
39202-2413
US

V. Phone/Fax

Practice location:
  • Phone: 601-353-7090
  • Fax: 601-353-7094
Mailing address:
  • Phone: 601-353-7090
  • Fax: 601-353-7094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOAN CATHERINE SENTENEY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 601-353-7090