Provider Demographics
NPI:1366814188
Name:PRX HEALTH INSTITUTE, LLC
Entity type:Organization
Organization Name:PRX HEALTH INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORY
Authorized Official - Middle Name:EMILE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-909-6274
Mailing Address - Street 1:814 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-4259
Mailing Address - Country:US
Mailing Address - Phone:601-909-6274
Mailing Address - Fax:601-909-6287
Practice Address - Street 1:232 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-3601
Practice Address - Country:US
Practice Address - Phone:601-909-6274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care