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Organization
AYERS MARTIN ENTERPRISES LLC
Active
Organization
AYERS MARTIN ENTERPRISES LLC
Active
Other names
MidSouth Pathology Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW AYERS MARTIN MD (PRESIDENT)
(601) 636-0097
Entity
Organization
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(601) 636-0097
(601) 629-9969
Mailing address
PO BOX 820662, VICKSBURG, MS 39182-0662
(601) 636-0097
(601) 629-9969
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
14355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115777
—
MS
Enumeration date
08/04/2008
Last updated
03/25/2014
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