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NPI Code Detail

MEDICARE: CENTRAL MISSISSIPPI HEALTH SERVICES, INC

MEDICARE: CENTRAL MISSISSIPPI HEALTH SERVICES, INC
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
1207R00000XInternal Medicine Physician
2207V00000XObstetrics & Gynecology Physician
3207Q00000XFamily Medicine Physician
4261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730120502
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL MISSISSIPPI HEALTH SERVICES, INC
Provider Business Mailing Address
First Line : 1134 WINTER ST
Second Line :
City : JACKSON
State : MS
Zip : 39204-2841
Country : US
Telephone Number : 601-948-5572
Fax Number : 601-353-7070
Provider Business Practice Location Address
First Line : 1134 WINTER ST
Second Line :
City : JACKSON
State : MS
Zip : 39204-2841
Country : US
Telephone Number : 601-948-5572
Fax Number : 601-353-7070
Authorized Official
Title or Position : HUMAN RESOURCE MANAGER
Name : TERRY JOHNSON
Credential :
Telephone Number : 601-948-5572
Provider Enumeration Date : 06/10/2006
Last Update Date : 04/28/2022

Similar Medicare Providers

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Practice Location Address:
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Practice Phone: 601-948-5572
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1154359842 — DR. EDITH FAYE SMITH RAYFORD M.D.
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1134158579 — DR. ZINA DARCEL LEE M.D.
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JACKSON, MS
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Practice Fax: 601-353-7070
1285663591 — DR. ROBERT SMITH M.D.
Practice Location Address:
1134 WINTER ST
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39204-2841
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Practice Fax: 601-353-7070
1851321384 — DR. OBIE M. MCNAIR M.D.
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1568598027 — MISS ERICKA M MICOU NP
Practice Location Address:
1134 WINTER ST
JACKSON, MS
39204-2841
Practice Phone: 601-948-5572
Practice Fax: 601-914-3012

Directions to “CENTRAL MISSISSIPPI HEALTH SERVICES, INC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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