Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Medical Mall Health Services of Mississippi, LLC

Organization Primary Care Nurse Practitioner · NPI 1194083139

Medical Mall Health Services of Mississippi, LLC provides Primary Care Nurse Practitioner services in Jackson, Mississippi. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

350 W Woodrow Wilson Ave Ste 499A
Jackson, MS 39213-7681 Not confirmed with CMS for 11 years — call before visiting
Phone: (601) 700-7709
Fax: (877) 852-6352
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X

Record details

NPI number1194083139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy McNeil — Coo · (202) 344-5465
NPI enumeratedApril 27, 2012
Last updated in NPPESMarch 12, 2015
Mailing address350 W Woodrow Wilson Ave., Suite 499a, Jackson, MS 39213-7681

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