Organization
JACKSON PUBLIC SCHOOLS NORTHWEST CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL WATKINS PH.D (SUPERINTENDENT)
(601) 960-8700
Entity
Organization
Contact information
Practice address
7020 HWY 49 N, JACKSON, MS 39213
(601) 713-1776
(601) 713-0579
Mailing address
662 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 960-8705
(601) 960-8704
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
08671872
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08671872
—
MS
Enumeration date
02/22/2007
Last updated
08/22/2020
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