| Reddix Medical Group | |
|
5903 Ridgewood Rd Ste 310 Jackson MS 39211-3702 | |
| (601) 899-3310 | |
| (601) 899-3314 |
| Full Name | Reddix Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 5903 Ridgewood Rd, Jackson, Mississippi |
| Authorized Official Name and Position | Carl M Reddix (PRESIDENT) |
| Authorized Official Contact | 6018993310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reddix Medical Group 5903 Ridgewood Rd Ste 310 Jackson MS 39211-3702 Ph: (601) 899-3310 | Reddix Medical Group 5903 Ridgewood Rd Ste 310 Jackson MS 39211-3702 Ph: (601) 899-3310 |
| NPI Number | 1811901242 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/20/2010 |
| Medicare PECOS PAC ID | 0941494686 |
|---|---|
| Medicare Enrollment ID | O20101027000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811901242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Maurice Mcshan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770597163 PECOS PAC ID: 4880887983 Enrollment ID: I20101021000719 |
| Provider Name | Natalie Y Brookins-reddix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720094196 PECOS PAC ID: 4082808738 Enrollment ID: I20101027000541 |
| Provider Name | Leondrea Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639608813 PECOS PAC ID: 5496025868 Enrollment ID: I20170816000194 |
| Provider Name | Dusharme Lakiva Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386367092 PECOS PAC ID: 2062850597 Enrollment ID: I20240403002606 |
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