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

The Pain Clinic of Mississippi, PLLC

Organization Pain Medicine Physician · NPI 1063786036

The Pain Clinic of Mississippi, PLLC is a Pain Medicine Physician in Jackson, Mississippi. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5903 Ridgewood Rd Ste 440
Jackson, MS 39211-3700
Phone: (601) 899-3989
Fax: (601) 899-3504
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X
Pain Medicine Physician Taxonomy 208VP0000X

Record details

NPI number1063786036
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Duane Williamson — President · (601) 899-3989
NPI enumeratedMarch 8, 2012
Last updated in NPPESMarch 8, 2012
Mailing addressPo Box 235019, Montgomery, AL 36123-5019

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