Organization
AYERS MARTIN ENTERPRISES LLC
Active
Other names
MidSouth Pathology Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW AYERS MARTIN MD (PRESIDENT)
(601) 636-0097
Entity
Organization
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(601) 636-0097
(601) 629-9969
Mailing address
PO BOX 820662, VICKSBURG, MS 39182-0662
(601) 636-0097
(601) 629-9969
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
14355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115777
—
MS
Enumeration date
08/04/2008
Last updated
03/25/2014
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