Region Xii Commission
NPI #1467767988 in Laurel, Mississippi
Provider Information
- NPI Number
- 1467767988
- Entity Type
- Organization
- Organization Name
- Region Xii Commission
- Primary Specialty
- General Practice
- Enumeration Date
- Aug 9, 2010
- Last Updated
- Aug 9, 2010
Practice Location
- Address
- 934 WEST DR
- City
- Laurel
- State
- Mississippi
- ZIP Code
- 39440-4702
- Phone
- (601) 426-7520
Authorized Official
- Name
- MR. JERRY MAYO
- Title
- EXECUTIVE DIRECTOR
- Phone
- (601) 544-4641
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
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