Organization
MEDICAL MALL SERVICES OF MISSISSIPPI, LLC
Active
Other names
Medical Mall Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CLAYTON BARDWELL (CHIEF FINANCIAL OFFICER)
(202) 459-4766
Entity
Organization
Contact information
Practice address
350 W WOODROW WILSON AVE, JACKSON, MS 39213-7681
(610) 672-2733
Mailing address
2820 BLADENSBURG RD NE, 2ND FLOOR, WASHINGTON, DC 20018-4106
(202) 459-4766
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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