Mississippi Childrens Heart Clinic PLLC
Pediatrics, Pediatric Cardiology in Jackson, MS. Organization (NPI-2).
NPI number1366042236
StatusActive
Last updated in NPPESOct 29, 2020
Details
- NPI
- 1366042236
- Entity type
- Organization (NPI-2)
- Legal business name
- Mississippi Childrens Heart Clinic PLLC
- Organization subpart
- No
- Enumeration date
- Oct 29, 2020
- Certification date
- Oct 29, 2020
- Last updated
- Oct 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0202X | Pediatrics, Pediatric Cardiology | – | – | Yes |
Other names
- Ms Children'S Heart (Doing Business As)
Practice location
1190 N State St Ste 200Jackson, MS 39202-2413
Phone 601-965-6100
Mailing address
Po Box 22646Jackson, MS 39225-2646
Phone 601-944-1717
Authorized official
Stephanie Purvis
Office Manager
6019656100
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