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Organization

ALCORN STATE UNIVERSITY

Active
Parent organization
ALCORN STATE UNIVERSITY
Other names
ASU FAMILY CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ALCORN STATE UNIVERSITY
Authorized official
DR. LINDA GODLEY (DIRECTOR)
(601) 304-4375
Entity
Organization

Contact information

Practice address
15 CAMPUS DR, NATCHEZ, MS 39120-5364
(601) 304-4375
(601) 304-4355
Mailing address
15 CAMPUS DR, NATCHEZ, MS 39120-5364
(601) 304-4334
(601) 304-4355

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
02/13/2007
Last updated
12/20/2007
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