# JACKSON PUBLIC SCHOOLS DBA BLACKBURN CLINIC

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

## Provider details

- **NPI number:** 1780729285
- **Authorized official:** DR. EARL WATKINS PH.D. (SUPERINTENDENT)
- **Authorized official phone:** (601) 960-8700

## Contact information

- **Practice address:** 1311 W PEARL ST, JACKSON, MS 39203-2841
- **Practice address phone:** (601) 354-3346
- **Practice address fax:** (601) 352-6436
- **Mailing address:** 662 S PRESIDENT ST, JACKSON, MS 39201-5601
- **Mailing address phone:** (601) 960-8705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WS0200X | School Registered Nurse | R629693 | MS | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 08/22/2020