Mississippi State University | |
325 Hardy Road Mississippi State MS 39762-9736 | |
(662) 325-1028 | |
Not Available |
Full Name | Mississippi State University |
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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 |
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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 |
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Provider Enumeration Date | 04/03/2013 |
Last Update Date | 04/03/2013 |
Identifier | Type | State | Issuer |
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1891038303 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | OT2774 (Mississippi) | Primary |
261QC1800X | Clinic/center - Corporate Health | OT2774 (Mississippi) | Secondary |
John C Longest Student Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 360 Hardy Rd, Mississippi State, MS 39762 Phone: 662-325-2431 Fax: 662-325-8888 |