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Organization

ANNYCE R. CAMPBELL M.D., PA.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNYCE RAMONA CAMPBELL M.D. (PHYSICIAN)
(769) 257-5713
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08563
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00012698
MS
Enumeration date
09/02/2014
Last updated
09/02/2014
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