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NPI Code Detail

MEDICARE: NORTH MISSISSIPPI MEDCIAL CENTER, INC.

MEDICARE: NORTH MISSISSIPPI MEDCIAL CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner877621MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467948687
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH MISSISSIPPI MEDCIAL CENTER, INC.
Provider Business Mailing Address
First Line : 808 VARSITY DR
Second Line :
City : TUPELO
State : MS
Zip : 38801-4613
Country : US
Telephone Number : 662-377-2774
Fax Number : 662-377-2057
Provider Business Practice Location Address
First Line : 738 S GLOSTER ST STE B
Second Line :
City : TUPELO
State : MS
Zip : 38801-4932
Country : US
Telephone Number : 662-377-3896
Fax Number : 662-377-5059
Authorized Official
Title or Position : CORPORATE SECRETARY
Name : BRUCE TOPPIN
Credential :
Telephone Number : 662-377-4226
Provider Enumeration Date : 07/11/2018
Last Update Date : 01/22/2025

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