Central Jackson Family Medical Clinic
LBN: Central Jackson Family Medical Clinic
Central Jackson Family Medical Clinic is an health care organization with primary practice located at 514 C Woodrow Wilson , Jackson MS 39216. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty.
Central Jackson Family Medical Clinic can be contacted via phone (601) 981-7198, or through Thomas, Cassandra Faye via phone (601) 981-7198.
Contact Information
Primary practice address
514 C Woodrow Wilson
Jackson MS 39216
Phone: (601) 981-7198
Fax: (601) 981-6616
Website:
Authorized official contact:
Name: Thomas, Cassandra Faye Doctor of Medicine (MD)
Phone: (601) 981-7198
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | 13653 | Mississippi |
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | 18905 | Mississippi |
Profile Details
| NPI number | 1154549707 |
|---|---|
| LBN Legal business name | Central Jackson Family Medical Clinic |
| DBA Doing business as | |
| Authorized official | Thomas, Cassandra Faye Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Dec 9th, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154549707 | NPPES |
| Mississippi | MEDICAID | 00937242 | |
| Mississippi | MEDICAID | 00112137 |
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