Individual
DR. MELINDA MULLINS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
701 NORTHSIDE DRIVE, CENTRAL MISSISSIPPI RESIDENTIAL CENTER, NEWTON, MS 36345-2361
(601) 683-4200
(601) 683-4269
Mailing address
4641 MAUREY RD, JACKSON, MS 39211-5625
(601) 594-6006
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11594
MS
2084P0800X
Psychiatry Physician
Primary
11594
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018302
—
MS
Enumeration date
10/16/2006
Last updated
07/21/2022
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