Organization
MISSISSIPPI LACTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL AUSTIN PUCKETT (CO-FOUNDER)
(601) 932-6455
Entity
Organization
Contact information
Practice address
435 KATHERINE DR STE B, FLOWOOD, MS 39232-9781
(601) 932-6455
Mailing address
PO BOX 321412, FLOWOOD, MS 39232-1412
(601) 932-6455
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
208000000X
Pediatrics Physician
Primary
9307
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014803
—
MS
Enumeration date
05/01/2015
Last updated
05/01/2015
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