Physician Assistant
ORTHO EXPRESS HOLDING COMPANY, LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1497396931 · enumerated 2019-10-07 · record updated 2025-10-01. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: JENNIFER BULLOCK, President · (662) 534-2227
Other names: ORTHOXPRESS OF SOUTHAVEN
Addresses and phones
- Mailing address 206 OXFORD RD, NEW ALBANY, MS, 38652-3115 (662) 534-2227 Google Maps Apple Maps OpenStreetMap
- Practice location 125 GOODMAN RD W STE D, SOUTHAVEN, MS, 38671-9481 (662) 932-3560 Fax (662) 534-2330 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner 363L00000X
- Physician Assistant 363A00000X · Primary
In this directory
Locations and evidence
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Practice location
SOUTHAVEN, MS, 386719481
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.