Organization
JACKSON THYROID & ENDOCRINE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WOODY SISTRUNK M.D. (OWNER)
(601) 949-6990
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 353, JACKSON, MS 39216-4643
(601) 949-6990
(601) 949-6105
Mailing address
971 LAKELAND DR, SUITE 353, JACKSON, MS 39216-4643
(601) 949-6990
(601) 949-6105
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
15819
MS
Other
Enumeration date
10/31/2016
Last updated
12/13/2019
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