Organization · Type 2 NPI

Premise Health of Mississippi Medical PC

Multi-Specialty Clinic/Center · Ridgeland, MS

NPI number 1417620360 Active

Practice location

1800 E County Line Rd Ste 400
Ridgeland, MS 39157-1916

Mailing address

5500 Maryland Way
Brentwood, TN 37027-7048

Specialties and licenses

TaxonomyCodeLicense
Multi-Specialty Clinic/Center Primary 261QM1300XNone listed

Multi-Specialty Clinic/Center: Definition to come...

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About NPI 1417620360

Premise Health of Mississippi Medical PC's National Provider Identifier is 1417620360, issued on Jul 27, 2021. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Ridgeland, MS. The record was last updated on Feb 4, 2026.