# CENTRAL MISSISSIPPI MEDICAL CLINIC PLLC

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

## Provider details

- **NPI number:** 1316813868
- **Authorized official:** JOSEPH WALKER BLACKSTON (OWNER)
- **Authorized official phone:** (601) 955-3223

## Contact information

- **Practice address:** 2200 HIGHWAY 61 N STE 2100, VICKSBURG, MS 39183-8246
- **Practice address phone:** (601) 955-3223
- **Mailing address:** 1900 PETIT BOIS ST N, JACKSON, MS 39211-6707
- **Mailing address phone:** (601) 955-3223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2025
- **Last updated:** 10/13/2025