Jackson State University
Jackson State University is a General Practice Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2016.
- Licensed in
- MS
- In the registry since
- 2016
Practice location Address checks out
1400 Jr Lynch StJackson, MS 39217-0002
Phone: (601) 979-2291
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X · Licence 09707 (MS) |
|---|
Record details
| NPI number | 1366991523 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mouzon Bass — Agent · (972) 367-4845 |
| Other names | Jackson State University Sports Medicine |
| NPI enumerated | September 29, 2016 |
| Last updated in NPPES | September 29, 2016 |
| Mailing address | 5050 Spring Valley Rd, Dallas, TX 75244-3995 |
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