Provider First Line Business Practice Location Address:
2500 NORTH STATE STREET
Provider Second Line Business Practice Location Address:
UNIVERSITY MISSISSIPPI MEDICAL CENTER - DEPT OF ORTHOPA
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-209-8708
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2024