Healthcare Provider Details

I. General information

NPI: 1255330163
Provider Name (Legal Business Name): SELECT SPECIALTY HOSPITAL - JACKSON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5903 RIDGEWOOD RD
JACKSON MS
39211-3700
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DEPT.
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 601-376-1099
  • Fax: 601-376-1013
Mailing address:
  • Phone: 717-972-1100
  • Fax: 717-975-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number22331
License Number StateMS

VIII. Authorized Official

Name: MR. JOHN DUGGAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100