Integrated Medical Staff Of Jackson Pc
Legal Business Name
Integrated Medical Staff Of Jackson Pc
NPI Number
1659779445
NPI Type
Organization
Enumeration Date
12/11/2014
Specialties
(Taxonomies)Name
Code
207L00000X
207RC0000X
207N00000X
207RE0101X
207RG0100X
207RH0000X
207RI0200X
207R00000X
207RI0011X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
828 N PARKWAY
828 N PARKWAY
City
Jackson
Jackson
State
TN
TN
Postal Code
38305-3032
38305-3032
Country
US
US
Telephone Number
(731) 422-0330
(731) 422-0330
Authorized Official
Name
Mr. Mark Allen
Title or Position
CEO
Telephone Number
(731) 422-0330
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/11/2014