Organization
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Other names
Holmes Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY GRIMSLEY (CHIEF FINANCIAL OFFICER)
(601) 815-8732
Entity
Organization
Contact information
Practice address
239 BOWLING GREEN ROAD, LEXINGTON, MS 39095
(662) 834-1321
(601) 815-6301
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06300013
—
MS
Enumeration date
08/09/2006
Last updated
05/08/2020
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