Organization
CENTRAL MISSISSIPPI HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY JOHNSON (HUMAN RESOURCES MANAGER)
(601) 948-5572
Entity
Organization
Contact information
Practice address
5429 ROBINSON ROAD EXT, JACKSON, MS 39204-4138
(601) 948-5572
(601) 353-7070
Mailing address
1134 WINTER ST, JACKSON, MS 39204-2841
(601) 948-5572
(601) 353-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08582355
—
MS
Enumeration date
02/14/2007
Last updated
04/28/2022
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