Organization
MEDICAL MALL HEALTH SERVICES OF MISSISSIPPI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY P MCNEIL RN (COO)
(202) 344-5465
Entity
Organization
Contact information
Practice address
350 W WOODROW WILSON AVE, SUITE 499A, JACKSON, MS 39213-7681
(601) 700-7709
(877) 852-6352
Mailing address
350 W WOODROW WILSON AVE., SUITE 499A, JACKSON, MS 39213-7681
(601) 700-7709
(877) 852-6352
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/27/2012
Last updated
03/12/2015
Update your record
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