# MISSISSIPPI UROLOGY CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MISSISSIPPI UROLOGY CLINIC, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851271159
- **Legal business name:** MISSISSIPPI UROLOGY CLINIC, PLLC
- **Authorized official:** HAROLD JASON BLALOCK (PRESIDENT)
- **Authorized official phone:** (601) 985-3169

## Contact information

- **Practice address:** 1029 RIVER OAKS DR, FLOWOOD, MS 39232-9554
- **Practice address phone:** (601) 353-9900
- **Practice address fax:** (601) 353-3654
- **Mailing address:** 501 MARSHALL ST STE 301, JACKSON, MS 39202-1687
- **Mailing address phone:** (601) 985-3169
- **Mailing address fax:** (601) 353-3654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 09/05/2025
- **Last updated:** 09/05/2025