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

Dr. Dereck Davis

Individual provider Pediatrics Physician · NPI 1174567580

Dr. Dereck Davis is a Pediatric Medicine in Jackson, Mississippi. Graduated from University of South Alabama College of Medicine in 2001, 25 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Mississippi and North Carolina.

Years since qualifying
25
Trained at
University of South Alabama College of Medicine
Licensed in
MS, NC
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

2600 N State St
Jackson, MS 39216-4301
Phone: (601) 984-5220
Fax: (601) 984-5279
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 18418 (MS)
Pediatrics Physician Taxonomy 208000000X · Licence 2007-00180 (NC)

Record details

NPI number1174567580
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 15, 2006
Last updated in NPPESAugust 11, 2014
Mailing address2600 N State St, Jackson, MS 39216-4301

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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