NPI 1952687717

Mitzi Ferguson, MD, LLC

Organisation General Practice Physician Jackson, MS

Practice location

Address: 4500 I 55 N Suite 215, Jackson, MS 39211-5930
Phone: (601) 212-0955
Mailing address: 1990 Petit Bois St N, Jackson, MS 39211-6707

Authorised official

Name: Susan C. Kerley
Title: Credentialing/Billing Specialist
Phone: (601) 957-7340

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 09298 (MS)

Other General Practice providers in Mississippi →

Registry record

NPI: 1952687717
Entity type: Organization
NPI issued: 25 Oct 2011
Record last updated: 25 Oct 2011

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.