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Organization
JACKSON BONE AND JOINT
Active
Organization
JACKSON BONE AND JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRISSETT (ADMINISTRATOR)
(601) 944-1717
Entity
Organization
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1000
Mailing address
1600 N STATE ST, STE 400, JACKSON, MS 39202-1689
(601) 944-1717
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116141
—
MS
05
—
09015408
—
MS
Enumeration date
03/20/2008
Last updated
03/20/2008
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