| Mitzi Ferguson, MD, LLC | |
|
4500 I 55 N Suite 215 Jackson MS 39211-5930 | |
| (601) 212-0955 | |
| Not Available |
| Full Name | Mitzi Ferguson, MD, LLC |
|---|---|
| Speciality | General Practice |
| Location | 4500 I 55 N, Jackson, Mississippi |
| Authorized Official Name and Position | Susan C. Kerley (CREDENTIALING/BILLING SPECIALIST) |
| Authorized Official Contact | 6019577340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mitzi Ferguson, MD, LLC 1990 Petit Bois St N Jackson MS 39211-6707 Ph: (601) 957-7344 | Mitzi Ferguson, MD, LLC 4500 I 55 N Suite 215 Jackson MS 39211-5930 Ph: (601) 212-0955 |
| NPI Number | 1952687717 |
|---|---|
| Provider Enumeration Date | 10/25/2011 |
| Last Update Date | 10/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952687717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 09298 (Mississippi) | Primary |
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