NPI 1851730121

Sonny Montgomer Vamc

Organisation Special Hospital Jackson, MS

Practice location

Address: 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116
Phone: (601) 362-4471

Authorised official

Name: Micah Dickson Taylor
Title: Outpatient LCSW
Phone: (601) 362-4471

Registered specialties

Special Hospital Primary

Hospitals Taxonomy 284300000X Licence C6323 (MS)

Other Special Hospital providers in Mississippi →

Registry record

NPI: 1851730121
Entity type: Organization
NPI issued: 20 Jun 2013
Record last updated: 20 Jun 2013

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.