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General NPI Number Information
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NPI Number | 1205070422
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Entity Type | Organization
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Legal Business Name | BALANCE SLEEP CENTERS OF MISSISSIPPI, JACKSON, LLC
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Dates
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Enumeration Date | 05/01/2009
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 403 TOWNE CENTER BLVD STE 102A
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City | RIDGELAND
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State | MS
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Zip | 39157-4843
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Country | US
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Telephone | 601-957-7779
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Fax | 601-957-7778
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Provider Business Mailing Address
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Address Line | PO BOX 1890
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City | RIDGELAND
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State | MS
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Zip | 39158-1890
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Country | US
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Telephone | 601-957-7779
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Fax | 601-957-7778
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Authorized Official
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Title or Position | OPERATING OWNER
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Name | DR. SAGAR H PATEL
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Credential | M.D.
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Telephone | 601-955-2656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 20272
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License Number State | MS
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