Healthcare Provider Details
I. General information
NPI: 1972324309
Provider Name (Legal Business Name): URGENT SPECIALTY ASSOCIATES OF MISSISSIPPI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 S GLOSTER ST
TUPELO MS
38801-4934
US
IV. Provider business mailing address
9635 MAROON CIR STE 410
ENGLEWOOD CO
80112-5927
US
V. Phone/Fax
- Phone: 855-495-1400
- Fax:
- Phone: 817-856-0655
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
JOSEPHS
Title or Position: PRESIDENT
Credential: MD
Phone: 469-766-8747