North Jackson Medical Clinic Pllc
LBN: North Jackson Medical Clinic Pllc
North Jackson Medical Clinic Pllc is an health care organization with primary practice located at 5160 Galaxie Dr , Jackson MS 39206-4308. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty.
North Jackson Medical Clinic Pllc can be contacted via phone (601) 713-0890, or through Shekoni, Adesola F via phone (601) 713-0890.
Contact Information
Primary practice address
5160 Galaxie Dr
Jackson MS 39206-4308
Phone: (601) 713-0890
Fax: (601) 366-3415
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15143 | Mississippi |
Profile Details
| NPI number | 1659471407 |
|---|---|
| LBN Legal business name | North Jackson Medical Clinic Pllc |
| DBA Doing business as | |
| Authorized official | Shekoni, Adesola F Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Apr 8th, 2008 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659471407 | NPPES |
| Mississippi | MEDICAID | 00117502 | |
| Mississippi | Other | 220338401B | |
| Mississippi | MEDICAID | 00115572 | |
| Mississippi | MEDICAID | 9015073 | |
| Mississippi | Other | 109808399B |
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