# PREMIER MEDICAL GROUP OF MISSISSIPPI LLC

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

## Provider details

- **NPI number:** 1790827038
- **Authorized official:** DR. JACKEY D TURNER M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (662) 289-1800

## Contact information

- **Practice address:** 332 HIGHWAY 12 W, KOSCIUSKO, MS 39090-3209
- **Practice address phone:** (662) 289-1800
- **Mailing address:** PO BOX 23996, JACKSON, MS 39225-3996
- **Mailing address phone:** (601) 206-6100
- **Mailing address fax:** (601) 206-6052

## Taxonomy

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

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 10/02/2008