Provider Demographics
NPI:1669424701
Name:MISSISSIPPI HEARING CENTER, INC
Entity type:Organization
Organization Name:MISSISSIPPI HEARING CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:LOCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:601-352-4613
Mailing Address - Street 1:1151 N STATE ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2407
Mailing Address - Country:US
Mailing Address - Phone:601-352-4613
Mailing Address - Fax:601-969-1976
Practice Address - Street 1:1151 N STATE ST
Practice Address - Street 2:SUITE 107
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2407
Practice Address - Country:US
Practice Address - Phone:601-352-4613
Practice Address - Fax:601-969-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS04537261QH0700X, 235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
Not Answered235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Single Specialty