Organization
MISSISSIPPI SPORTS MEDICINE & ORTHOPAEDIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEREDITH GORE WARF (CEO)
(601) 605-5393
Entity
Organization
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 949-9106
(601) 351-5980
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 351-5980
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013483
—
MS
01
—
374507100
ACS/DEPT. OF LABOR
MS
01
—
CB3252
MEDICARE RR GROUP NUMBER
MS
Enumeration date
05/19/2006
Last updated
11/03/2025
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