Chadwick Drive Clinic

LBN: Jackson Pediatric Associates P A
Chadwick Drive Clinic is an health care organization with primary practice located at 1824 Hospital Dr , Jackson MS 39204-3410. 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 P A can be contacted via phone (601) 346-4586, or through Wilson, Yolanda W via phone (601) 707-5381.

Contact Information

Primary practice address
1824 Hospital Dr Jackson MS 39204-3410
Phone: (601) 346-4586
Fax: (601) 346-4587
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 1659556298
LBN Legal business name Jackson Pediatric Associates P A
DBA Doing business as Chadwick Drive Clinic
Authorized official Wilson, Yolanda W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 2nd, 2008
Last updated Nov 15th, 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 1659556298 NPPES
Mississippi MEDICAID 07325898

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