Healthcare Provider Details

I. General information

NPI: 1407110554
Provider Name (Legal Business Name): CHASITY LYNNE TORRENCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 HIGHWAY 80 W
JACKSON MS
39209
US

IV. Provider business mailing address

P.O. BOX 7777
JACKSON MS
39284
US

V. Phone/Fax

Practice location:
  • Phone: 601-321-2400
  • Fax: 601-321-2476
Mailing address:
  • Phone: 601-321-2400
  • Fax: 601-321-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22962
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: