Organization
JACKSON PUBLIC SCHOOLS DBA BLACKBURN 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
1311 W PEARL ST, JACKSON, MS 39203-2841
(601) 354-3346
(601) 352-6436
Mailing address
662 S PRESIDENT ST, JACKSON, MS 39201-5601
(601) 960-8705
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R629693
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09570093
—
MS
Enumeration date
02/21/2007
Last updated
08/22/2020
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