# ANNYCE R. CAMPBELL M.D., PA.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063812683
- **Authorized official:** ANNYCE RAMONA CAMPBELL M.D. (PHYSICIAN)
- **Authorized official phone:** (769) 257-5713

## Contact information

- **Practice address:** 4510 HANGING MOSS RD, JACKSON, MS 39206-3962
- **Practice address phone:** (769) 257-5713
- **Practice address fax:** (769) 257-5715
- **Mailing address:** 4510 HANGING MOSS RD, JACKSON, MS 39206-3962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 08563 | MS | Yes |

## Other

- **Enumeration date:** 09/02/2014
- **Last updated:** 09/02/2014