Healthcare Provider Details

I. General information

NPI: 1952200586
Provider Name (Legal Business Name): MIMP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 LELIA DR STE 408
JACKSON MS
39216-4828
US

IV. Provider business mailing address

901 N STATE ST # 4371
JACKSON MS
39202-2627
US

V. Phone/Fax

Practice location:
  • Phone: 662-238-9052
  • Fax:
Mailing address:
  • Phone: 662-238-9052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCELINO MARTINEZ
Title or Position: MEMBER
Credential:
Phone: 662-238-9052