Organization
MCCOMB UROLOGY CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE BENJAMIN SIMO MD (PRESIDENT)
(601) 684-1261
Entity
Organization
Contact information
Practice address
300 RAWLS DR STE 1000, MCCOMB, MS 39648-2861
(601) 684-1261
(601) 684-3649
Mailing address
300 RAWLS DR STE 1000, MCCOMB, MS 39648-2861
(601) 684-1261
(601) 684-3649
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7944
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016344
—
MS
Enumeration date
10/06/2006
Last updated
07/21/2022
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