Advanced Diagnostic Pain Center, PLLC
Organization Active NPI Pain Medicine (Anesthesiology) Physician · Jackson, MS
NPI 1972706646 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1972706646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine (Anesthesiology) Physician 207LP2900X
- License
- 19739 (MS)
- Legal business name
- ADVANCED DIAGNOSTIC PAIN CENTER, PLLC
- Practice address
- 5903 Ridgewood Rd
440
Jackson, MS 39211-3700 - Phone
- (601) 899-3990
- Fax
- (601) 899-3920
- NPI assigned
- Jun 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Carol D Harris, M.D.
- Title
- Owner
- Phone
- (601) 899-3990
National Provider Directory
Locations
1883 Highway 43 S
Ste F
Canton, MS 39046
Phone (601) 859-5455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | 19739 | MS | |
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | 19739 | MS | Yes |
Addresses
Primary practice location
5903 Ridgewood Rd
440
Jackson, MS 39211-3700
Mailing address
5903 Ridgewood Rd
440
Jackson, MS 39211-3700
Phone (601) 899-3990
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All providers in Jackson, MS · Pain Medicine (Anesthesiology) 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 Sep 11, 2025. 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.