Jackson Public Schools Dba Blackburn Clinic

LBN: Jackson Public Schools Dba Blackburn Clinic
Jackson Public Schools Dba Blackburn Clinic is an health care organization with primary practice located at 1311 W Pearl St , Jackson MS 39203-2841. The organization recently has only one registered license in Nursing Service Providers / School, which is considered as the primary health care specialty. Jackson Public Schools Dba Blackburn Clinic can be contacted via phone (601) 354-3346, or through Watkins, Earl via phone (601) 960-8700.

Contact Information

Primary practice address
1311 W Pearl St Jackson MS 39203-2841
Phone: (601) 354-3346
Fax: (601) 352-6436
Website:
Map and Directions
Authorized official contact:
Name: Watkins, Earl PH.D.
Phone: (601) 960-8700

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X R629693 Mississippi

Profile Details

NPI number 1780729285
LBN Legal business name Jackson Public Schools Dba Blackburn Clinic
DBA Doing business as
Authorized official Watkins, Earl PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2007
Last updated Aug 22nd, 2020 - about 4 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 1780729285 NPPES
Mississippi MEDICAID 09570093

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