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

State of Mississippi - University of Mississippi Medical Center

Organization Orthopaedic Surgery Physician · NPI 1639898877

State of Mississippi - University of Mississippi Medical Center is an Orthopaedic Surgery Physician in Jackson, Mississippi. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2500 N State Street Big Mouth Bass Clinic - Sanderson Tower - Level B
Jackson, MS 39216-4500
Phone: (601) 984-6025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X
Prosthetic/Orthotic Supplier Taxonomy 335E00000X

Record details

NPI number1639898877
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Grimsley — Cfo · (601) 815-6270
Other names Big Mouth Bass Clinic - Sanderson Tower - Level B
NPI enumeratedAugust 23, 2022
Last updated in NPPESMay 1, 2024
Certification dateMay 1, 2024
Mailing address504 Clinton Center Drive, Cbo - Suite 4300, Clinton, MS 39056

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