Jackson Pediatric Associates

LBN: Jackson Pediatric Associates
Jackson Pediatric Associates is an health care organization with primary practice located at 297 Highway 51 Ste B , Ridgeland MS 39157-3423. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Jackson Pediatric Associates can be contacted via phone (601) 707-5381, or through Wilson, Yolanda W via phone (601) 707-5381.

Contact Information

Primary practice address
297 Highway 51 Ste B Ridgeland MS 39157-3423
Phone: (601) 707-5381
Fax: (601) 707-5382
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Yolanda W Doctor of Medicine (MD)
Phone: (601) 707-5381

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 12555 Mississippi

Profile Details

NPI number 1457484594
LBN Legal business name Jackson Pediatric Associates
DBA Doing business as
Authorized official Wilson, Yolanda W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Nov 16th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457484594 NPPES
Mississippi MEDICAID 09015867

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