Healthcare Provider Details

I. General information

NPI: 1720231301
Provider Name (Legal Business Name): UNIVERSITY PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NORTH STATE STREET
JACKSON MS
39216-4505
US

IV. Provider business mailing address

2500 NORTH STATE STREET
JACKSON MS
39216-4505
US

V. Phone/Fax

Practice location:
  • Phone: 601-815-4775
  • Fax: 601-984-6451
Mailing address:
  • Phone: 601-984-6441
  • Fax: 601-815-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT P STRINGER
Title or Position: PRESIDENT
Credential: MD
Phone: 601-984-6441