Organization
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA HILLMAN (OFFICE DIRECTOR)
(601) 906-0879
Entity
Organization
Contact information
Practice address
570 E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 906-0879
Mailing address
570 E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 906-0879
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019240
—
MS
Enumeration date
01/30/2007
Last updated
12/02/2022
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