Provider First Line Business Practice Location Address:
2500 NORTH STATE STREET THE UNIVERSITY OF MISSISSIPPI
Provider Second Line Business Practice Location Address:
MEDICAL CENTER FAMILY MEDICINE DEPARTMENT
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:
601-984-5826
Provider Business Practice Location Address Fax Number:
601-984-6889
Provider Enumeration Date:
05/06/2015