Organization
JACKSON ONCOLOGY ASSOCIATES, PLLC
Active
Parent organization
JACKSON ONCOLOGY ASSOCIATES, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON ONCOLOGY ASSOCIATES, PLLC
Authorized official
KIM WARD (CHIEF OPERATIONS OFFICER)
(601) 974-5513
Entity
Organization
Contact information
Practice address
2200 HIGHWAY 61 N STE 3300, VICKSBURG, MS 39183-8246
(601) 638-3447
(601) 630-9227
Mailing address
1227 N STATE ST STE 101, JACKSON, MS 39202-2002
(601) 355-2485
(601) 353-1463
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03330910
—
MS
Enumeration date
03/05/2007
Last updated
11/09/2021
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