# JEFFERSON COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Emergency Room Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225247505
- **Authorized official:** MR. JERRY KENNEDY (ADMINISTRATOR)
- **Authorized official phone:** (601) 786-3401

## Contact information

- **Practice address:** 870 MAIN STREET, FAYETTE, MS 39069
- **Practice address phone:** (601) 786-3401
- **Practice address fax:** (601) 786-3400
- **Mailing address:** 870 MAIN STREET, FAYETTE, MS 39069
- **Mailing address phone:** (601) 786-3401
- **Mailing address fax:** (601) 786-3400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 14997 | MS | — |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | 07965 | MS | Yes |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | 14721 | MS | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | 16670 | MS | — |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 09/11/2025