OrganizationActive
Defining Wellness Medical Center
NPI 1053050591 · Behavioral Neurology & Neuropsychiatry Physician · Ridgeland, MS
Provider details
- NPI number
- 1053050591
- Entity type
- Organization
- Primary specialty
- Behavioral Neurology & Neuropsychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sonya Mukherjee, Director of Revenue Cycle(754) 261-8405
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Group Psychotherapy Psychologist103TP2701X
Behavioral Health & Social Service Providers
Practice location
411 Hanover Cir Ste 100
Ridgeland, MS 39157-8814
Phone: (855) 761-1582
Fax: (769) 241-2605
Approximate (ZIP-level) locationGet directions
Mailing address
3949 Highway 43 N
Brandon, MS 39047-7240
Registry dates
- Enumerated
- 2022-06-02
- Last updated
- 2022-06-02
- Certified
- 2022-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.