| Mississippi State University | |
|
195 Lee Blvd Mississippi State MS 39762-9698 | |
| (662) 325-5895 | |
| (662) 325-8888 |
| Full Name | Mississippi State University |
|---|---|
| Speciality | Family Medicine |
| Location | 195 Lee Blvd, Mississippi State, Mississippi |
| Authorized Official Name and Position | Daniel Todd Hale (DIRECTOR, FISCAL OPERATIONS, STUDEN) |
| Authorized Official Contact | 6623255895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi State University Po Box 6338 Mississippi State MS 39762-6338 Ph: (662) 325-5895 | Mississippi State University 195 Lee Blvd Mississippi State MS 39762-9698 Ph: (662) 325-5895 |
| NPI Number | 1356208367 |
|---|---|
| Provider Enumeration Date | 01/09/2026 |
| Last Update Date | 01/09/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356208367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mississippi State University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 360 Hardy Rd, Mississippi State, MS 39762 Phone: 662-325-2431 Fax: 662-325-8888 |