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UNIVERSITY NEUROLOGY GROUP, PLLC

Clinical Neuropsychologist

Jackson, Mississippi

Provider NPI: 1770599110

Organization Information:
Organization Name:  UNIVERSITY NEUROLOGY GROUP, PLLC
Organization is not Subpart
Authorized Official:  JAMES J. CORBETT  CHAIR AND MANAGING PARTNER  601-9845500

Practice Location:
2500 NORTH STATE STREET  JACKSON, MS 39216 US
Tel: 601-984-5500  Fax: 601-984-5499

Business Mailing Address:
PO BOX 4528  JACKSON, MS 39296 US
Tel: 601-984-5500  Fax: 601-984-5499

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
Y2084N0400XPhysicians
Psychiatry & Neurology

Other Provider Identifiers:

IssuerNumberStateType
9012340MS05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS MS - Page 1



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