Organization
PREFERRED PHP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISHAN K GUPTA MD (CEO)
(601) 957-3211
Entity
Organization
Contact information
Practice address
1059 RIDGEWOOD PL FL 2, JACKSON, MS 39211-2018
(601) 957-3211
(601) 957-9753
Mailing address
PO BOX 13531, JACKSON, MS 39236-3531
(601) 957-3211
(601) 957-9753
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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