Individual
DR. MARK RUNNELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1421 N STATE ST, STE 403, JACKSON, MS 39202-1658
(601) 353-9900
(601) 353-3654
Mailing address
501 MARSHALL ST, STE 301, JACKSON, MS 39202-1687
(601) 353-9900
(601) 353-3654
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
T-2356
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23772
STATE LICENSE
MS
Enumeration date
07/03/2010
Last updated
10/10/2018
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