Organization
JACKSON LUNG CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FRAZIER MD (MANAGING OWNER)
(601) 936-6001
Entity
Organization
Contact information
Practice address
1151 N STATE ST, SUITE 301, JACKSON, MS 39202-2407
(601) 352-0041
(601) 352-0043
Mailing address
PO BOX 967, JACKSON, MS 39205-0967
(601) 936-6001
(601) 936-4389
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015305
—
MS
Enumeration date
11/30/2006
Last updated
08/22/2020
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