Organization
MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD J BLALOCK MD (OWNER)
(601) 353-9900
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 201, JACKSON, MS 39202-1651
(601) 353-9900
(601) 353-3654
Mailing address
501 MARSHALL ST, SUITE 201, JACKSON, MS 39202-1651
(601) 353-9900
(601) 353-3654
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/01/2015
Last updated
03/21/2017
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