Premise Health of Mississippi Medical, P.c.
NPI #1619640562 in Forest, Mississippi
Provider Information
- NPI Number
- 1619640562
- Entity Type
- Organization
- Organization Name
- Premise Health of Mississippi Medical, P.c.
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Jul 27, 2021
- Last Updated
- Oct 13, 2022
Practice Location
- Address
- 1001 FOUNTAIN DR
- City
- Forest
- State
- Mississippi
- ZIP Code
- 39074-4038
- Phone
- (601) 469-0234
Authorized Official
- Name
- JONATHAN LEIZMAN
- Title
- PRESIDENT
- Phone
- (216) 479-9063
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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