Organization
MIDSOUTH NEURO BEHAVIORAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WILSON (MANAGER)
(662) 328-5949
Entity
Organization
Contact information
Practice address
519 ALABAMA ST, COLUMBUS, MS 39702-5305
(662) 328-5949
Mailing address
519 ALABAMA ST, COLUMBUS, MS 39702-5305
(662) 328-5949
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/22/2008
Last updated
03/22/2008
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