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General NPI Number Information
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NPI Number | 1609679240
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 2500 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39216-4500
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 320 MAIN ST
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City | PATTERSON
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State | LA
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Zip | 70392-4320
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN
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Name | DR. MARY JORDAN MELANCON
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Credential | MD
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Telephone | 225-439-8343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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