Individual
MACK WOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900
(601) 984-5939
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900
(601) 984-5939
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19651
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06082713
—
MS
05
—
191640
—
AL
05
—
2126318
—
MS
01
—
302I054121
MEDICARE PTAN
MS
Enumeration date
07/05/2007
Last updated
10/25/2016
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