Organization
MEDICAL MALL HEALTH SERVICES, LLC
Active
Other names
Medical Mall Health Services of Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C BARDWELL (CHIEF FINANCIAL OFFICER)
(202) 448-2983
Entity
Organization
Contact information
Practice address
450 WOODROW WILSON DRIVE, SUITE 499A, JACKSON, MS 39312-4101
(601) 500-7709
Mailing address
2820 BLADENSBURG ROAD, NE, WASHINGTON, DC 20018-4101
(202) 448-2983
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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