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Organization

SKY INTEGRATIVE MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHAMEKIA BENNETT B.S. (MANAGER)
(601) 617-7717
Entity
Organization

Contact information

Practice address
408 FONTAINE PL STE 104, RIDGELAND, MS 39157-5189
(601) 617-7717
(601) 398-0381
Mailing address
408 FONTAINE PL STE 104, RIDGELAND, MS 39157-5189
(601) 617-7717
(601) 398-0381

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06454351
MS
Enumeration date
01/26/2023
Last updated
01/26/2023
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