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Contact Information

JACKSON PAIN CENTER PA
1151 N STATE ST
SUITE 311
JACKSON, MS39202-2407
 Phone: 601-355-7246
 Fax: 601-969-1173
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for JACKSON PAIN CENTER PA · (Female)

NPI # 1962823344
Status Active
Credentials
Entity Individual
Enumeration date 01/02/2014
Last updated 07/21/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS License # 10764
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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