# CENTRAL MS PEDIATRIC ENDOCRINOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114118940
- **Authorized official:** BRAD SINCLAIR (REGIONAL MANAGER)
- **Authorized official phone:** (601) 936-3102

## Contact information

- **Practice address:** 1860 CHADWICK DR, SUITE 206, JACKSON, MS 39204-3463
- **Practice address phone:** (601) 376-1517
- **Practice address fax:** (601) 376-1546
- **Mailing address:** 1860 CHADWICK DR, SUITE 206, JACKSON, MS 39204-3463
- **Mailing address phone:** (601) 376-1517
- **Mailing address fax:** (601) 376-1546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2007
- **Last updated:** 08/07/2007