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Ellisville State School
Clinic/Center in Ellisville, Mississippi
NPI 1568468080

Ellisville State School is a Clinic/Center based in Ellisville, MS. Ellisville State School practices in Ellisville, MS. The NPI Number for Ellisville State School is 1568468080 and holds a License No. C00638 (Mississippi).

The current practice location address for Ellisville State School is 1101 Hwy 11 S, Ellisville, MS and can be reached out via phone at 601-477-9384 and via fax at 601-477-5700.

Location: 1101 Hwy 11 S, Ellisville, MS, 39437-4444
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568468080
Provider Name
Ellisville State School
Credential
Provider Entity Type
Organization
Address
1101 Hwy 11 S, Ellisville, MS, 39437-4444
Phone Number
601-477-9384
Fax Number
601-477-5700
Provider Enumeration Date
06/21/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1101 Hwy 11 S
City
Ellisville
State
Mississippi
Zip
39437-4444
Phone Number
601-477-9384
Fax Number
601-477-5700
person
Provider Business Mailing Address Details
Address
1101 Hwy 11 S
City
Ellisville
State
Mississippi
Zip
39437-4444
Phone Number
601-477-9384
Fax Number
601-477-5700
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
C00638 (Mississippi)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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