Mississippi Urology Clinic, PLLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

MISSISSIPPI UROLOGY CLINIC, PLLC

Practice address

1029 River Oaks Dr
Flowood, MS 39232-9554

Phone

(601) 353-9900

Fax

(601) 353-3654

NPI assigned

Sep 5, 2025

Last updated

Sep 5, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

MISSISSIPPI UROLOGY CLINIC, PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Harold Jason BlalockNPI 1730118696

Title

President

Phone

(601) 985-3169

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mississippi Urology Clinic PLLC2 organizations share this tax ID, including this one

Part of

Mississippi Urology Clinic PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mississippi Urology Clinic, PLLC

  • Non-Pharmacy Dispensing Site
  • Flowood, MS
  • NPI 1487432852
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harold Jason Blalock, M.D.

  • Urology Physician
  • Jackson, MS
  • NPI 1730118696
  Authorized official Same address or phone
• Charles L Secrest, MD

  • Urology Physician
  • Fort Worth, TX
  • NPI 1588695654
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1851271159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 301",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-985-3169",
            "fax_number": "601-353-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329554",
            "telephone_number": "601-353-9900",
            "fax_number": "601-353-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI UROLOGY CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSISSIPPI UROLOGY CLINIC, PLLC",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-985-3169"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi Organ Recovery Agency
• Mississippi Pain Management, PLLC
• Mississippi PHS MD LLC
• Mississippi Rheumatology and Osteoporosis Center PLLC
• Mississippi Urology Clinic, PLLC
• Mississippi Vision Correction Center, PLLC
• Mitchell Dental Clinic, Inc
• Ashley Myers Mitchell, LAT, ATC
• Lexi Mitchell
• Tonya Gail Mitchell, LMSW

• Non-Pharmacy Dispensing Site in Flowood, MS
• Providers in Flowood, MS by specialty
• Non-Pharmacy Dispensing Site in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.