Fondren Care Clinic

LBN: Hmg Group Llc
Fondren Care Clinic is an health care organization with primary practice located at 4436 N State St Suite A1, Jackson MS 39206-5334. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Hmg Group Llc can be contacted via phone (601) 383-2036, or through Gibson, Johnathan Chad via phone (601) 951-9197.

Contact Information

Primary practice address
4436 N State St Suite A1 Jackson MS 39206-5334
Phone: (601) 383-2036
Fax: (601) 981-5819
Website:
Map and Directions
Authorized official contact:
Name: Gibson, Johnathan Chad
Phone: (601) 951-9197

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 07980 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X R860365 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R878138 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R860365 Mississippi

Profile Details

NPI number 1255738035
LBN Legal business name Hmg Group Llc
DBA Doing business as Fondren Care Clinic
Authorized official Gibson, Johnathan Chad
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2014
Last updated Nov 22nd, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1255738035 NPPES
Mississippi MEDICAID 04136595
Mississippi MEDICAID 03727355
Mississippi MEDICAID 04457077

Popular Providers