Organization
UNIVERSITY PREVENTIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SARA LYNN STUBBS (SUPERVISOR BILLING COLLECTIONS)
(601) 984-1925
Entity
Organization
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1925
(601) 984-1916
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4505
(601) 984-1925
(601) 984-1916
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014153
—
MS
Enumeration date
04/27/2007
Last updated
07/21/2022
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