Healthcare Provider Details

I. General information

NPI: 1669424701
Provider Name (Legal Business Name): MISSISSIPPI HEARING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 N STATE ST SUITE 107
JACKSON MS
39202-2407
US

IV. Provider business mailing address

1151 N STATE ST SUITE 107
JACKSON MS
39202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 601-352-4613
  • Fax: 601-969-1976
Mailing address:
  • Phone: 601-352-4613
  • Fax: 601-969-1976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number04537
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number04537
License Number StateMS

VIII. Authorized Official

Name: DR. MYRON WILLIS LOCKEY
Title or Position: PRESIDENT/OWNER
Credential: M. D.
Phone: 601-352-4613