Organization
V A SOUTH
Active
Other names
V A SOUTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS T HARRIS PT (OWNER)
(601) 927-7671
Entity
Organization
Contact information
Practice address
4304 HIGHWAY 80 W STE A, JACKSON, MS 39209-5922
(601) 636-6019
(601) 661-8457
Mailing address
PO BOX 3183, RIDGELAND, MS 39158-3183
(601) 636-6019
(601) 661-8457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3192
MS
225X00000X
Occupational Therapist
OT2019
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124552
—
MS
Enumeration date
12/21/2006
Last updated
09/11/2025
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