Organization
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL ADCOCK (CHIEF OPERATIONS OFFICER)
(601) 576-7635
Entity
Organization
Contact information
Practice address
570 E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 576-7582
Mailing address
PO BOX 1700, JACKSON, MS 39215-1700
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015788
—
MS
Enumeration date
02/01/2007
Last updated
08/22/2020
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