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General NPI Number Information
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NPI Number | 1356208367
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI STATE UNIVERSITY
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 195 LEE BLVD
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City | MISSISSIPPI STATE
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State | MS
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Zip | 39762-9698
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Country | US
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Telephone | 662-325-5895
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Fax | 662-325-8888
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Provider Business Mailing Address
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Address Line | PO BOX 6338
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City | MISSISSIPPI STATE
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State | MS
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Zip | 39762-6338
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Country | US
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Telephone | 662-325-5895
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Fax | 662-325-8888
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Authorized Official
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Title or Position | DIRECTOR, FISCAL OPERATIONS, STUDEN
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Name | DANIEL TODD HALE
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Credential |
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Telephone | 662-325-5895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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