Organization
CENTRAL MISSISSIPPI MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WALKER BLACKSTON (OWNER)
(601) 955-3223
Entity
Organization
Contact information
Practice address
2200 HIGHWAY 61 N STE 2100, VICKSBURG, MS 39183-8246
(601) 955-3223
Mailing address
1900 PETIT BOIS ST N, JACKSON, MS 39211-6707
(601) 955-3223
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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