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Organization
JACKSON LIVER AND GI SPECIALISTS INC.
Active
Organization
JACKSON LIVER AND GI SPECIALISTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN BORG MD MHSC (PRESIDENT AND CEO)
(769) 251-5674
Entity
Organization
Contact information
Practice address
971 LAKELAND DR STE 1159, JACKSON, MS 39216-4609
(769) 251-5674
Mailing address
971 LAKELAND DR STE 1159, JACKSON, MS 39216-4609
(769) 251-5674
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02752313
—
MS
Enumeration date
07/28/2017
Last updated
04/26/2019
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