Healthcare Provider Details

I. General information

NPI: 1447148317
Provider Name (Legal Business Name): APEX MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 315
JACKSON MS
39216-4607
US

IV. Provider business mailing address

971 LAKELAND DR STE 315
JACKSON MS
39216-4607
US

V. Phone/Fax

Practice location:
  • Phone: 601-918-2995
  • Fax:
Mailing address:
  • Phone: 601-918-2995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOMJADE JAY SONGCHAROEN
Title or Position: PRESIDENT
Credential: MD
Phone: 601-918-2995