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NPI Code Detail

MEDICARE: NORTH MISSISSIPPI CLINICS LLC

MEDICARE: NORTH MISSISSIPPI CLINICS LLC
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
1207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1720789944
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH MISSISSIPPI CLINICS LLC
Provider Business Mailing Address
First Line : 499 GLOSTER CREEK VLG STE A2
Second Line :
City : TUPELO
State : MS
Zip : 38801-4749
Country : US
Telephone Number : 662-620-6800
Fax Number : 662-620-6950
Provider Business Practice Location Address
First Line : 616 ALCORN DR
Second Line :
City : CORINTH
State : MS
Zip : 38834-9393
Country : US
Telephone Number : 662-331-1973
Fax Number : 662-331-1974
Authorized Official
Title or Position : CEO
Name : WENDY CHISHOLM
Credential :
Telephone Number : 662-620-6800
Provider Enumeration Date : 03/14/2023
Last Update Date : 04/08/2026

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Directions to “NORTH MISSISSIPPI CLINICS LLC ” Practice Location

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