Organization
BEHAVIORAL MEDICINE CLINIC,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY JORDAN M.M. (OWNER)
(601) 482-2400
Entity
Organization
Contact information
Practice address
5000 HWY 39 N, MERIDIAN, MS 39301-1021
(601) 482-2400
Mailing address
5000 HWY 39 N, MERIDIAN, MS 39301-1021
(601) 482-2400
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
14095
MS
Other
Enumeration date
12/04/2007
Last updated
06/01/2010
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