Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNIE SMITH (RESPIRATORY TECHNICAL DIRECTOR)
(601) 362-4471
Entity
Organization
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
5044 HARLING PL, JACKSON, MS 39211-4731
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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