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Contact Information

JACKSON PSYCHIATRY GROUP
201 NORTHLAKE AVE STE 207
RIDGELAND, MS39157-1715
 Phone: 601-366-4696
 Fax: 601-414-9486
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JACKSON PSYCHIATRY GROUP

NPI Number 1629378971
LBN Legal business name JACKSON PSYCHIATRY GROUP
Authorized official DOUGLAS BYRD - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/02/2010
Last updated 06/19/2025 - About 12 months ago
Identifiers
MS License # 15999
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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