MEDICARE: IVX HEALTH OF MISSISSIPPI, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1538954938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IVX HEALTH OF MISSISSIPPI, PC

Provider Business Mailing Address
First Line	:	214 CENTERVIEW DR STE 250
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-3248
Country	:	US
Telephone Number	:	615-610-3733
Fax Number	:	844-206-0796

Provider Business Practice Location Address
First Line	:	6542 GOODMAN RD STE 115
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-5560
Country	:	US
Telephone Number	:	662-368-6300
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	WILLIAM SEIBELS
Credential	:
Telephone Number	:	615-610-3727

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	06/15/2026

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