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Organization
MISSISSIPPI BAPTIST MEDICAL CENTER
Active
Organization
MISSISSIPPI BAPTIST MEDICAL CENTER
Active
Other names
MBMC - Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY DUCKETT (SR VP/ CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1362
(601) 292-4592
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
196
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07984288
—
MS
Enumeration date
03/02/2007
Last updated
09/30/2020
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