Mansel, John Keith

Mansel, John Keith is an individual health care provider with primary practice located at 2500 N State Street , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, which is considered as his primary health care specialty. Mansel, John Keith can be contacted via phone (601) 984-5602.

Contact Information

Primary practice address
2500 N State Street Jackson MS 39216-4500
Phone: (601) 984-5602
Fax: (601) 984-6439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 08768 Mississippi

Profile Details

NPI number 1528242724
LBN Legal business name Mansel, John Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 24th, 2007
Last updated Dec 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528242724 NPPES
Mississippi Other 08768 FREE CLINIC
Mississippi MEDICAID 00115528 FREE CLINIC
Mississippi MEDICAID ENROLLED FREE CLINIC
Mississippi Other P01064280 FREE CLINIC
Mississippi MEDICAID ENROLLED FREE CLINIC

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