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Organization
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC.
Active
Organization
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC.
Active
Other names
Baptist Neurological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH H. MULLINS (DIRECTOR OF CLINIC ADMINISTRATION)
(601) 292-4261
Entity
Organization
Contact information
Practice address
1200 N STATE ST, SUITE 420, JACKSON, MS 39202-2001
(601) 355-3353
(601) 355-3365
Mailing address
PO BOX 2153, DEPT 1947, BIRMINGHAM, AL 35287-0001
(601) 355-3353
(601) 355-3365
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
NULL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01627892
—
MS
01
—
C02783
MEDICARE GROUP NUMBER
MS
01
—
DA0407
RR MEDICARE
—
Enumeration date
11/30/2007
Last updated
06/28/2013
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