Organization
JACKSON LIVER AND GI SPECIALISTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN BORG MD MHSC (PRESIDENT AND CEO)
(769) 251-5674
Entity
Organization
Contact information
Practice address
971 LAKELAND DR STE 1159, JACKSON, MS 39216-4609
(769) 251-5674
Mailing address
971 LAKELAND DR STE 1159, JACKSON, MS 39216-4609
(769) 251-5674
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02752313
—
MS
Enumeration date
07/28/2017
Last updated
04/26/2019
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