Healthcare Provider Details

I. General information

NPI: 1811699440
Provider Name (Legal Business Name): THE JOINT INJECTION CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 I 55 N
JACKSON MS
39206-5602
US

IV. Provider business mailing address

4755 I 55 N
JACKSON MS
39206-5602
US

V. Phone/Fax

Practice location:
  • Phone: 724-988-9028
  • Fax:
Mailing address:
  • Phone: 724-988-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE KUM-NJI
Title or Position: MANAGER
Credential: MD
Phone: 724-988-9028