# PREMIER MEDICAL GROUP OF MISSISSIPPI LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson Medical Clinic LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548219884
- **Authorized official:** MR. JAMES C BETHEA (CEO)
- **Authorized official phone:** (601) 352-2273

## Contact information

- **Practice address:** 501 MARSHALL ST, SUITE 208, JACKSON, MS 39202-1651
- **Practice address phone:** (601) 352-2273
- **Practice address fax:** (601) 353-4414
- **Mailing address:** PO BOX 23996, JACKSON, MS 39225-3996
- **Mailing address phone:** (601) 206-6113
- **Mailing address fax:** (601) 206-6052

## Taxonomy

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

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 02/16/2009