Mcwillie Elementary School Clinic

LBN: Jackson Public Schools Mcwillie Clinic
Mcwillie Elementary School Clinic is an health care organization with primary practice located at 4851 Mcwillie Cir , Jackson MS 39206-5025. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Jackson Public Schools Mcwillie Clinic can be contacted via phone (601) 209-4456, or through Crocker, Tammy D via phone (601) 209-4456.

Contact Information

Primary practice address
4851 Mcwillie Cir Jackson MS 39206-5025
Phone: (601) 209-4456
Fax: (601) 960-8704
Website:
Map and Directions
Authorized official contact:
Name: Crocker, Tammy D Registered Nurse (RN)
Phone: (601) 209-4456

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1518140599
LBN Legal business name Jackson Public Schools Mcwillie Clinic
DBA Doing business as Mcwillie Elementary School Clinic
Authorized official Crocker, Tammy D Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2007
Last updated Dec 12th, 2007 - about 17 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 1518140599 NPPES
Mississippi MEDICAID 02074355

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