Organization
MISSISSIPPI STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TODD HALE (DIRECTOR, FISCAL OPERATIONS, STUDEN)
(662) 325-5895
Entity
Organization
Contact information
Practice address
195 LEE BLVD, MISSISSIPPI STATE, MS 39762-9698
(662) 325-5895
(662) 325-8888
Mailing address
PO BOX 6338, MISSISSIPPI STATE, MS 39762-6338
(662) 325-5895
(662) 325-8888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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