Organization
WILLIAM MCCALLISTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CHARLES MCCALLISTER (LPN)
(769) 572-5002
Entity
Organization
Contact information
Practice address
1600 RAYMOND RD, JACKSON, MS 39204-4203
(601) 371-1700
Mailing address
704 FOREST AVE, JACKSON, MS 39206-3308
(769) 572-5002
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
P326102
MS
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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