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
100 TAMBERLINE ST, BRANDON, MS 39042-3164
(601) 825-2141
Mailing address
PO BOX 1700, JACKSON, MS 39215-1700
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016408
—
MS
Enumeration date
01/30/2007
Last updated
08/22/2020
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