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Organization
JACKSON PUBLIC SCHOOLS MCWILLIE CLINIC
Active
Organization
JACKSON PUBLIC SCHOOLS MCWILLIE CLINIC
Active
Other names
McWillie Elementary School Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY D CROCKER R.N. (LEAD NURSE)
(601) 209-4456
Entity
Organization
Contact information
Practice address
4851 MCWILLIE CIR, JACKSON, MS 39206-5025
(601) 209-4456
(601) 960-8704
Mailing address
618 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 960-8705
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02074355
—
MS
Enumeration date
12/12/2007
Last updated
12/12/2007
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