Organization
CLINIC FOR WOMEN OF CENTRAL MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE FAY MABRY (OFFICE MANAGER)
(601) 372-1541
Entity
Organization
Contact information
Practice address
1820 HOSPITAL DR, JACKSON, MS 39204-3410
(601) 372-1541
(601) 373-5141
Mailing address
1820 HOSPITAL DR, JACKSON, MS 39204-3410
(601) 372-1541
(601) 373-5141
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09597
MS
Other
Enumeration date
05/18/2006
Last updated
08/22/2020
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