| Mississippi State University | |
|
325 Hardy Road Mississippi State MS 39762-9736 | |
| (662) 325-1028 | |
| Not Available |
| Full Name | Mississippi State University |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 325 Hardy Road, Mississippi State, Mississippi |
| Authorized Official Name and Position | Eric Knox (OCCUPATIONAL THERAPIST) |
| Authorized Official Contact | 6623251028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi State University 325 Hardy Road Mississippi State MS 39762-0721 Ph: () - | Mississippi State University 325 Hardy Road Mississippi State MS 39762-9736 Ph: (662) 325-1028 |
| NPI Number | 1891038303 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 04/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891038303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | OT2774 (Mississippi) | Primary |
| 261QC1800X | Clinic/center - Corporate Health | OT2774 (Mississippi) | Secondary |
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 | |
Mississippi State University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 Lee Blvd, Mississippi State, MS 39762 Phone: 662-325-5895 Fax: 662-325-8888 |