Provider Demographics
NPI:1477825800
Name:THE MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
Entity Type:Organization
Organization Name:THE MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
Other - Org Name:BAPTIST VALVE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL CLINIC OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-292-4261
Mailing Address - Street 1:501 MARSHALL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-1651
Mailing Address - Country:US
Mailing Address - Phone:601-969-7047
Mailing Address - Fax:601-948-1417
Practice Address - Street 1:501 MARSHALL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1651
Practice Address - Country:US
Practice Address - Phone:601-969-7047
Practice Address - Fax:601-948-1417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center