# STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
- **Other names:** Midtown Mobile Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285126029
- **Legal business name:** STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
- **Authorized official:** MR. JEFFREY GRIMSLEY (INTERIM CFO)
- **Authorized official phone:** (601) 815-8732

## Contact information

- **Practice address:** 258 E FORTIFICATION ST, JACKSON, MS 39202-2356
- **Practice address phone:** (601) 815-8230
- **Mailing address:** 2500 N STATE ST, JACKSON, MS 39216-4500
- **Mailing address phone:** (601) 984-6270
- **Mailing address fax:** (601) 815-4119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/06/2018
- **Last updated:** 06/06/2018