Provider Demographics
NPI:1457535056
Name:UTILIZATION MANAGEMENT
Entity Type:Organization
Organization Name:UTILIZATION MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,CCM,CPUR,CNLCP
Authorized Official - Phone:601-605-2023
Mailing Address - Street 1:PO BOX 1859
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-1859
Mailing Address - Country:US
Mailing Address - Phone:601-605-2023
Mailing Address - Fax:
Practice Address - Street 1:576 HIGHLAND COLONY PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8769
Practice Address - Country:US
Practice Address - Phone:601-605-2023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9923719302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization