Capital City Children and Adolescent Clinic

NPI #1912088790 in Jackson, Mississippi

Provider Information

NPI Number: 1912088790
Entity Type: Organization
Organization Name: Capital City Children and Adolescent Clinic
Primary Specialty: Pediatrics
Enumeration Date: Oct 18, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 2679 CRANE RIDGE DR
Address 2: STE F
City: Jackson
State: Mississippi
ZIP Code: 39216-4997
Phone: (601) 362-7476

Authorized Official

Name: GERALDINE CHANEY
Title: OWNER
Phone: (601) 362-7476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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