Organization
GREATER JACKSON PHYSICIAN GROUP
Active
Other names
Greater Jackson Physician Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA M SWILLEY (OWNER)
(601) 968-0985
Entity
Organization
Contact information
Practice address
501 MARSHALL ST STE 501, JACKSON, MS 39202-1615
(601) 968-0985
(601) 960-0583
Mailing address
501 MARSHALL ST STE 501, JACKSON, MS 39202-1615
(601) 899-3990
(601) 960-0583
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06373834
—
MS
Enumeration date
06/09/2014
Last updated
07/21/2016
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