Organization Name: | MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC. |
NPI Number: | 1003098096 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH H. MULLINS (DIRECTOR OF CLINIC ADMINISTRATION) |
Mailing Address: | 1200 N State St Suite 420 Jackson |
State: | MS US |
Postal Code: | 392022001 |
Phone Number: | 6013553353 |
Fax Number: | 6013553365 |
NPI Enumeration Date: | 11/30/2007 |
NPI Last Update Date: | 06/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |