Organization
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM KENNEDY (ASSOCIATE ADMINISTOR)
(601) 986-4699
Entity
Organization
Contact information
Practice address
2500 N STATE ST, PFS, JACKSON, MS 39216-4500
(601) 984-4619
(601) 984-4657
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2342
(601) 984-4657
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
363L00000X
Nurse Practitioner
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015456
—
MS
01
—
CH5738
RR MEDICARE
MS
Enumeration date
10/20/2006
Last updated
04/20/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us