Organization
BURROW PATHOLOGY LABORATORIES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TURNER L. WILLIS M.D. (PRESIDENT)
(601) 684-0465
Entity
Organization
Contact information
Practice address
305 RAWLS DR, MCCOMB, MS 39648-2833
(601) 684-0465
(601) 684-3031
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
12940
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
12940
MS
291U00000X
Clinical Medical Laboratory
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123769
—
MS
05
—
1938637
—
LA
Enumeration date
02/06/2006
Last updated
07/09/2010
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