Healthcare Provider Details

I. General information

NPI: 1710341771
Provider Name (Legal Business Name): SISTERS IN BIRTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 OLD CANTON RD STE 280
JACKSON MS
39216-4255
US

IV. Provider business mailing address

5839 PEAR ORCHARD RD STE 1
JACKSON MS
39211-3311
US

V. Phone/Fax

Practice location:
  • Phone: 769-572-0000
  • Fax: 833-644-8146
Mailing address:
  • Phone: 601-953-9993
  • Fax: 601-487-6894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GETTY E ISRAEL
Title or Position: CEO/PRESIDENT
Credential: MPH
Phone: 601-953-9993