Jackson Medical Clinic Llc

LBN: Premier Medical Group Of Mississippi Llc
Jackson Medical Clinic Llc is an health care organization with primary practice located at 501 Marshall St Suite 208, Jackson MS 39202-1651. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Premier Medical Group Of Mississippi Llc can be contacted via phone (601) 352-2273, or through Bethea, James C via phone (601) 352-2273.

Contact Information

Primary practice address
501 Marshall St Suite 208 Jackson MS 39202-1651
Phone: (601) 352-2273
Fax: (601) 353-4414
Website:
Map and Directions
Authorized official contact:
Name: Bethea, James C
Phone: (601) 352-2273

Health care specialties

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

Profile Details

NPI number 1548219884
LBN Legal business name Premier Medical Group Of Mississippi Llc
DBA Doing business as Jackson Medical Clinic Llc
Authorized official Bethea, James C
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2006
Last updated Feb 16th, 2009 - about 15 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 1548219884 NPPES
Mississippi MEDICAID 09014760
Mississippi Other CD1075

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