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Jackson State University

NPI 1366991523ActiveOrganization· General Practice· Jackson, MS

General Practice in Jackson, Mississippi, registered in NPPES in September 2016. The authorized official on file is Mouzon Bass, Agent.

Overview

NPI1366991523
StatusActive
Entity typeOrganization
NPI issuedSep 29, 2016
Last updated in NPPESSep 29, 2016

Specialties and licenses

TaxonomyCodeLicenseState
General Practice Primary208D00000X09707MS

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other General Practice providers in Jackson

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