Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PREMIER MEDICAL GROUP OF MISSISSIPPI LLC
Active
Organization
PREMIER MEDICAL GROUP OF MISSISSIPPI LLC
Active
Other names
Jackson Medical Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES C BETHEA (CEO)
(601) 352-2273
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 208, JACKSON, MS 39202-1651
(601) 352-2273
(601) 353-4414
Mailing address
PO BOX 23996, JACKSON, MS 39225-3996
(601) 206-6113
(601) 206-6052
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014760
—
MS
01
—
CD1075
RAILROAD MEDICARE
MS
Enumeration date
05/05/2006
Last updated
02/16/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers