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Contact Information

ADVANCED DIAGNOSTIC PAIN CENTER, PLLC
5903 RIDGEWOOD RD
440
JACKSON, MS39211-3700
 Phone: 601-899-3990
 Fax: 601-899-3920
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for ADVANCED DIAGNOSTIC PAIN CENTER PLLC · (Female)

NPI Number 1972706646
Status Active
Credentials
Entity Individual
Enumeration date 06/08/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • MS License # 19739
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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