Organization
PROFESSIONAL HEALTH SERVICES OF JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. H WARREN COLE (CEO/OWNER)
(731) 660-8467
Entity
Organization
Contact information
Practice address
233 OIL WELL RD STE E, JACKSON, TN 38305-8014
(731) 660-8467
(731) 660-8495
Mailing address
233 OIL WELL RD STE E, JACKSON, TN 38305-8014
(731) 660-8467
(731) 660-8495
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3382556
—
TN
05
—
3926019
—
TN
01
—
556710000
MAGELLAN BEHAVIORAL HEALT
TN
01
—
7567489
AETNA
TN
Enumeration date
09/13/2006
Last updated
02/20/2009
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