# JACKSON ANESTHESIA ASSOCIATES PA

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1780737577
- **Authorized official:** MRS. JOYCE MARTIN (CREDENTIALING)
- **Authorized official phone:** (601) 969-1171

## Contact information

- **Practice address:** 1151 N STATE ST, SUITE 311, JACKSON, MS 39202
- **Practice address phone:** (601) 969-1171
- **Practice address fax:** (601) 969-6749
- **Mailing address:** PO BOX 22656, JACKSON, MS 39225-2656
- **Mailing address phone:** (888) 502-0531
- **Mailing address fax:** (601) 969-6749

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 11/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09013225 | — | MS |