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Organization
UROLOGY CLINIC OF MERIDIAN, P.A.
Active
Organization
UROLOGY CLINIC OF MERIDIAN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK T PHILLIPS M.D. (OWNER)
(601) 693-1055
Entity
Organization
Contact information
Practice address
1302 20TH AVE, MERIDIAN, MS 39301-4120
(601) 693-1055
(601) 482-5312
Mailing address
1302 20TH AVE, MERIDIAN, MS 39301-4120
(601) 693-1055
(601) 482-5312
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
11068
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08536025
—
MS
Enumeration date
10/17/2006
Last updated
04/09/2008
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