# ON DEMAND MEDICAL TESTING II

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

## Provider details

- **NPI number:** 1295488393
- **Authorized official:** RONALD HEWITT (CEO)
- **Authorized official phone:** (601) 966-5601

## Contact information

- **Practice address:** 4510 OFFICE PARK DR, JACKSON, MS 39206-6016
- **Practice address phone:** (601) 966-5601
- **Mailing address:** 4510 OFFICE PARK DR, JACKSON, MS 39206-6016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/28/2022
- **Last updated:** 01/28/2022