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General NPI Number Information
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NPI Number | 1205868593
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Entity Type | Organization
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Legal Business Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3312 OAK ST
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City | VICKSBURG
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State | MS
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Zip | 39180-5042
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Country | US
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Telephone | 601-629-9500
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Fax | 601-638-9044
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Provider Business Mailing Address
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Address Line | 3502 W NORTHSIDE DR
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City | JACKSON
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State | MS
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Zip | 39213-4454
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Country | US
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Telephone | 601-362-5321
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Fax | 601-364-2600
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Authorized Official
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Title or Position | CEO
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Name | DR. JASMIN CHAPMAN
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Credential | DDS
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Telephone | 601-362-5321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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