Organization · NPI-2
Flowood River Oaks Hma Medical Group, LLC
Internal Medicine · Flowood, MS
NPI number1801128798
StatusActive
Last updated in NPPESJan 11, 2023
Details
- NPI
- 1801128798
- Entity type
- Organization (NPI-2)
- Legal business name
- Flowood River Oaks Hma Medical Group, LLC
- Organization subpart
- Yes
- Enumeration date
- Feb 3, 2010
- Certification date
- Jan 11, 2023
- Last updated
- Jan 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207P00000X | Emergency Medicine | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207Y00000X | Otolaryngology | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 208M00000X | Hospitalist | – | – | |
| 231H00000X | Audiologist | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
1030 River Oaks DrFlowood, MS 39232-9553
Phone 239-598-3131 · Fax 239-598-9433
Mailing address
Po Box 689022Franklin, TN 37068-9022
Phone 615-465-7000 · Fax 615-628-6877
Authorized official
Jennifer L Jackson
Senior Director Provider Enrollment
6154657000
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