Organization · Type 2 NPI
Premise Health of Mississippi Medical PC
Multi-Specialty Clinic/Center · Forest, MS
NPI number
1619640562
Active
Practice location
1001 Fountain Dr
Forest, MS 39074-4038
Mailing address
5500 Maryland Way
Brentwood, TN 37027-7048
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
About NPI 1619640562
Premise Health of Mississippi Medical PC's National Provider Identifier is 1619640562, issued on Jul 27, 2021. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Forest, MS. The record was last updated on Feb 12, 2026.