| Mississippi Farm Bureau - Jackson | |
|
6311 Ridgewood Rd Jackson MS 39211-2035 | |
| (601) 977-8270 | |
| Not Available |
| Full Name | Mississippi Farm Bureau - Jackson |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6311 Ridgewood Rd, Jackson, Mississippi |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Farm Bureau - Jackson 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Mississippi Farm Bureau - Jackson 6311 Ridgewood Rd Jackson MS 39211-2035 Ph: (601) 977-8270 |
| NPI Number | 1063185916 |
|---|---|
| Provider Enumeration Date | 07/27/2021 |
| Last Update Date | 10/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063185916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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