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Organization

JEFFERSON COUNTY HOSPITAL

Active
Other names
Jefferson County Hospital ER Physician Claims
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY KENNEDY (ADMINISTRATOR)
(601) 786-3401
Entity
Organization

Contact information

Practice address
870 MAIN STREET, FAYETTE, MS 39069
(601) 786-3401
(601) 786-3400
Mailing address
870 MAIN STREET, FAYETTE, MS 39069
(601) 786-3401
(601) 786-3400

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
07965
MS
207Q00000X
Family Medicine Physician
14997
MS
207R00000X
Internal Medicine Physician
16670
MS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
14721
MS

Other

Enumeration date
05/23/2007
Last updated
09/11/2025
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