Healthcare Provider Details

I. General information

NPI: 1083671895
Provider Name (Legal Business Name): A & A HEALTH SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 WATKINS DR STE A
JACKSON MS
39206-2034
US

IV. Provider business mailing address

5440 WATKINS DR STE A
JACKSON MS
39206-2034
US

V. Phone/Fax

Practice location:
  • Phone: 601-981-3636
  • Fax: 601-982-5335
Mailing address:
  • Phone: 601-981-3636
  • Fax: 601-982-5335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERYLL FLETCHER-VINCENT
Title or Position: OFFICER
Credential: MD
Phone: 601-981-3636