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Individual

BILLY E. MINK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
12864
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00126149
MS
05
1131717
LA
Enumeration date
06/14/2006
Last updated
06/14/2012
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