John Jefferson Beddingfield III, M.D.
Individual provider Active NPI Psychiatry Physician · Jackson, MS
NPI 1386663201 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1386663201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 11006 (MS)
- Practice address
- 1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116 - Phone
- (601) 362-4471
- Fax
- (601) 364-1395
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11006 | MS | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 11006 | MS | Yes |
Addresses
Primary practice location
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Mailing address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone (601) 957-9125
Other providers in Jackson, MS
- Regina Spencer Beckham
- Marlon Beckley
- Beckwith Family Chiropractic, LLC
- John C. Beckwith
- Margaret Reimers Beckwith
- Sarika Chandak Bedi
- Bee Well LLC
- Diane K Beebe
- Angela Aldridge Beem
- Beemon Drugs Inc
All providers in Jackson, MS · Psychiatry Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.