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General NPI Number Information
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NPI Number | 1023285046
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Entity Type | Organization
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Legal Business Name | JACKSON STATE UNIVERSITY
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 350 W WOODROW WILSON AVE
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City | JACKSON
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State | MS
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Zip | 39213-7681
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Country | US
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Telephone | 601-979-1531
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18199
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City | JACKSON
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State | MS
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Zip | 39217-0001
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Country | US
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Telephone | 601-979-1531
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT FOR RESEARCH AND FED
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Name | DR. FELIX OKOJIE
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Credential |
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Telephone | 601-979-2931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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