Organization
UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAPHNE SECREST (ADMINISTRATIVE)
(601) 815-9384
Entity
Organization
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6562
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
759-L
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WP832764
CANADIAN PASSPORT#
—
Enumeration date
07/07/2009
Last updated
07/07/2009
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