Provider Demographics
NPI:1205070422
Name:BALANCE SLEEP CENTERS OF MISSISSIPPI, JACKSON, LLC
Entity type:Organization
Organization Name:BALANCE SLEEP CENTERS OF MISSISSIPPI, JACKSON, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-955-2656
Mailing Address - Street 1:PO BOX 1890
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-1890
Mailing Address - Country:US
Mailing Address - Phone:601-957-7779
Mailing Address - Fax:601-957-7778
Practice Address - Street 1:403 TOWNE CENTER BLVD STE 102A
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4843
Practice Address - Country:US
Practice Address - Phone:601-957-7779
Practice Address - Fax:601-957-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20272207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty