Provider Demographics
NPI:1255685202
Name:HIX, JARROD MICHAEL (PA-C)
Entity Type:Individual
Prefix:
First Name:JARROD
Middle Name:MICHAEL
Last Name:HIX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HALLS CV
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-6620
Mailing Address - Country:US
Mailing Address - Phone:662-562-9003
Mailing Address - Fax:662-562-4007
Practice Address - Street 1:103 HALLS CV
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-6620
Practice Address - Country:US
Practice Address - Phone:662-562-9003
Practice Address - Fax:662-562-4007
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2220363A00000X
MSPA00585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant