Organization
MEDICAL GENETIC CONSULTANTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY C BURKHARDT JR. PH.D. (DIRECTOR, OWNER, PRESIDENT)
(228) 872-3680
Entity
Organization
Contact information
Practice address
819 DESOTO ST, OCEAN SPRINGS, MS 39564-3707
(228) 872-3680
(228) 872-2563
Mailing address
819 DESOTO ST, OCEAN SPRINGS, MS 39564-3707
(228) 872-3680
(228) 872-2563
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119936
—
MS
05
—
009918250
—
AL
05
—
1552976
—
LA
01
—
25D0651912
CLIA NUMBER
MS
Enumeration date
01/15/2007
Last updated
10/06/2011
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