Individual
DR. KOFI ODURO-BOADU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5426
(601) 984-6889
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5426
(601) 984-6889
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
T-4311
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/06/2021
Last updated
05/31/2022
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