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NPI Code Detail

MEDICARE: MISSISSIPPI STATE DEPARTMENT OF HEALTH

MEDICARE: MISSISSIPPI STATE DEPARTMENT OF HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477604908
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSISSIPPI STATE DEPARTMENT OF HEALTH
Provider Business Mailing Address
First Line : PO BOX 1700
Second Line :
City : JACKSON
State : MS
Zip : 39215-1700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 TAMBERLINE ST
Second Line :
City : BRANDON
State : MS
Zip : 39042-3164
Country : US
Telephone Number : 601-825-2141
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATIONS OFFICER
Name : MITCHELL ADCOCK
Credential :
Telephone Number : 601-576-7635
Provider Enumeration Date : 01/12/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
100 TAMBERLINE ST
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1023154366 — MISSISSIPPI STATE DEPARTMENT OF HEALTH
Practice Location Address:
100 TAMBERLINE ST
BRANDON, MS
39042-3164
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1124164561 — MISSISSIPPI STATE DEPARTMENT OF HEALTH
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100 TAMBERLINE ST
BRANDON, MS
39042-3164
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Practice Fax:
1740324698 — BOBBY JOE WOLFE JR.
Practice Location Address:
100 TAMBERLINE ST
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39042-3164
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Practice Fax:

Directions to “MISSISSIPPI STATE DEPARTMENT OF HEALTH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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