Organization
JACKSON SURGICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN FREDERICK PARKER II MD (GENERAL SURGEON)
(601) 946-2200
Entity
Organization
Contact information
Practice address
1190 N STATE ST, SUITE L01, JACKSON, MS 39202-2413
(601) 292-4292
Mailing address
1600 N STATE ST, SUITE 400, JACKSON, MS 39202-1689
(601) 944-1717
(601) 944-9780
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
06450
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013125
—
MS
Enumeration date
12/03/2007
Last updated
04/25/2014
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