Provider Demographics
NPI:1881458271
Name:COGGINS, JORDAN ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ASHLEY
Last Name:COGGINS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-6803
Mailing Address - Country:US
Mailing Address - Phone:228-669-8256
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Practice Address - Street 2:2500 N STATE STREET
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39047
Practice Address - Country:US
Practice Address - Phone:228-669-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program