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General NPI Number Information
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NPI Number | 1821199654
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Entity Type | Organization
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Legal Business Name | GREATER MERIDIAN HEALTH CLINIC, INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 2701 DAVIS ST
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City | MERIDIAN
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State | MS
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Zip | 39301-5708
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Country | US
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Telephone | 601-693-0118
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Fax | 844-778-8922
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Provider Business Mailing Address
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Address Line | 2701 DAVIS ST
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City | MERIDIAN
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State | MS
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Zip | 39301-5708
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Country | US
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Telephone | 601-693-0118
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Fax | 601-693-2988
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Authorized Official
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Title or Position | CEO
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Name | WILBERT L. JONES
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Credential |
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Telephone | 601-693-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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