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General NPI Number Information
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NPI Number | 1609960749
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Entity Type | Organization
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Legal Business Name | MAXILLOFACIAL SURGERY CENTER OF CENTRAL MISSISSIPPI
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 266 KATHERINE DR
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City | JACKSON
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State | MS
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Zip | 39232-8801
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Country | US
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Telephone | 601-420-3223
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Fax | 601-420-3054
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Provider Business Mailing Address
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Address Line | 266 KATHERINE DR
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City | JACKSON
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State | MS
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Zip | 39232-8801
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Country | US
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Telephone | 601-420-3223
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Fax | 601-420-3054
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. J JOEL DRUMMOND
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Credential | D.M.D., M.D.
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Telephone | 601-420-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3119.00
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2820.94
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 05.339.00
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 05.340.00
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 16843
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 16896
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License Number State | MS
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