Organization
MISSISSIPPI FOOT CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIE JAMES LEWIS SR. D.P.M. (OWNER/PRESIDENT)
(601) 355-0026
Entity
Organization
Contact information
Practice address
128 POINDEXTER ST, JACKSON, MS 39203-3048
(601) 355-0026
(601) 355-0069
Mailing address
PO BOX 10529, JACKSON, MS 39289-0529
(601) 355-0026
(601) 355-0069
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
80062
MS
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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