Organization
JACKSON PUBLIC SCHOOLS HARDY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL WATKINS PH.D. (SUPERINTENDENT)
(601) 960-8700
Entity
Organization
Contact information
Practice address
545 ELLIS AVE, JACKSON, MS 39209-6202
(601) 960-8705
(601) 960-8704
Mailing address
662 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 960-8705
(601) 960-8704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R557579
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04835581
—
MS
Enumeration date
02/21/2007
Last updated
08/22/2020
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