Organization
JACKSON NEUROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARMILA TIWARI (MANAGER)
(601) 981-0034
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 1151, JACKSON, MS 39216-4643
(601) 981-0034
(601) 981-0099
Mailing address
971 LAKELAND DR, SUITE 1151, JACKSON, MS 39216-4643
(601) 981-0034
(601) 981-0099
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06921064
—
MS
Enumeration date
07/05/2006
Last updated
08/22/2020
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