Organization
JACKSON VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J BALTZ D.O (CENTER DIRECTOR)
(601) 364-1359
Entity
Organization
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1298
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1298
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/20/2006
Last updated
08/22/2020
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