NPI 1013014695
Sonny Montgomery V a M Edical Center
Practice location
- Address
- 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116
- Phone
- (601) 362-4471
- Mailing address
- 1973 Houston Rd, Bolton, MS 39041-9387
Authorised official
- Name
- Linda Ruth Mack
- Title
- Certified Nurse Practitioner
- Phone
- (601) 362-4471
Registered specialties
Chronic Disease Hospital
Primary
Registry record
- NPI
- 1013014695
- Entity type
- Organization
- NPI issued
- 17 Sep 2006
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.