Organization
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC
Active
Other names
Baptist Medical Clinic Lakeshore-Byram
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH H MULLINS (DIRECTOR OF CLINIC ADMINISTRATION)
(601) 292-4261
Entity
Organization
Contact information
Practice address
7275 S SIWELL RD, JACKSON, MS 39272-9776
(601) 373-7722
(601) 373-7378
Mailing address
7275 S SIWELL RD, JACKSON, MS 39272-9776
(601) 373-7722
(601) 373-7378
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014667
—
MS
Enumeration date
03/30/2007
Last updated
08/22/2020
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