Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medical Mall Health Services of Mississippi, LLC

Organization Primary Care Nurse Practitioner · NPI 1194083139

Medical Mall Health Services of Mississippi, LLC is a Primary Care Nurse Practitioner in Jackson, Mississippi. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

350 W Woodrow Wilson Ave Ste 499A
Jackson, MS 39213-7681
Phone: (601) 700-7709
Fax: (877) 852-6352
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X

Record details

NPI number1194083139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy McNeil — Coo · (202) 344-5465
NPI enumeratedApril 27, 2012
Last updated in NPPESMarch 12, 2015
Mailing address350 W Woodrow Wilson Ave., Suite 499a, Jackson, MS 39213-7681

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