| Jeffersonr LLC | |
|
509 Central Ave Ste 243 Laurel MS 39440-3938 | |
| (601) 517-2789 | |
| Not Available |
| Full Name | Jeffersonr LLC |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 509 Central Ave Ste 243, Laurel, Mississippi |
| Authorized Official Name and Position | Jefferson Lee Graham Rogers (PSYCHIATRIST) |
| Authorized Official Contact | 6015172789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffersonr LLC 1481 Grantham Rd Sumrall MS 39482-4089 Ph: (601) 517-2789 | Jeffersonr LLC 509 Central Ave Ste 243 Laurel MS 39440-3938 Ph: (601) 517-2789 |
| NPI Number | 1134908072 |
|---|---|
| Provider Enumeration Date | 09/28/2023 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134908072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Primary |
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