Organization
MISSISSIPPI DEPARTMENT OF REHABILITAION SVS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. H.S. BUTCH MCMILLAN (EXECUTIVE DIRECTOR)
(601) 853-5200
Entity
Organization
Contact information
Practice address
1281 HIGHWAY 51 NORTH, JACKSON, MS 39215-1698
(601) 853-5324
(601) 853-5301
Mailing address
1281 HIGHWAY 51 NORTH, P.O. BOX 1698, JACKSON, MS 39215-1698
(601) 853-5324
(601) 853-5301
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770022
—
MS
05
—
00770536
—
MS
Enumeration date
05/04/2007
Last updated
08/22/2020
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