Organization
J FAILS, LLC
Active
Other names
Lucedale Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FAILS NP-C (OWNER)
(601) 953-3433
Entity
Organization
Contact information
Practice address
2210 MILL STREET EXT STE D, LUCEDALE, MS 39452-6079
(601) 953-3433
Mailing address
309 WELLINGTON WAY, BRANDON, MS 39047-8362
(601) 953-3433
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06852827
—
MS
Enumeration date
01/11/2021
Last updated
01/11/2021
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