Healthcare Provider Details

I. General information

NPI: 1295642395
Provider Name (Legal Business Name): MISSISSIPPI BAPTIST MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MARSHALL ST STE G1
JACKSON MS
39202-1651
US

IV. Provider business mailing address

501 MARSHALL ST STE G1
JACKSON MS
39202-1651
US

V. Phone/Fax

Practice location:
  • Phone: 901-227-4133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREGORY M DUCKETT
Title or Position: OFFICER SECRETARY
Credential:
Phone: 901-227-5233