Sonny Montgomer Vamc
NPI #1851730121 in Jackson, Mississippi
Provider Information
- NPI Number
- 1851730121
- Entity Type
- Organization
- Organization Name
- Sonny Montgomer Vamc
- Primary Specialty
- Special Hospital
- Enumeration Date
- Jun 20, 2013
- Last Updated
- Jun 20, 2013
Practice Location
- Address
- 1500 E WOODROW WILSON AVE
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-5116
- Phone
- (601) 362-4471
Authorized Official
- Name
- MICAH DICKSON TAYLOR, LCSW
- Title
- OUTPATIENT LCSW
- Phone
- (601) 362-4471
Specialties & Taxonomy Codes
| Specialty |
|---|
| Special Hospital |
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