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Contact Information

JACKSON ANESTHESIA PAIN CENTER, LLC
1190 N STATE ST
SUITE 300
JACKSON, MS39202-2413
 Phone: 601-709-0607
 Fax: 601-709-2110
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

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

NPI # 1104166362
Status Active
Credentials
Entity Individual
Enumeration date 02/26/2013
Last updated 02/26/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS License # 12138
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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