Organization
VETERANS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE K TAYLOR (CREDENTIALING SUPERVISOR)
(601) 362-4471
Entity
Organization
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
112 QUAIL RUN DR, MADISON, MS 39110-9108
(601) 853-7673
(601) 510-6234
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
R788397
MS
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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