MEDICARE: GREENWOOD LEFLORE HOSPITAL

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1740259282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENWOOD LEFLORE HOSPITAL

Provider Business Mailing Address
First Line	:	803 1ST ST
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2309
Country	:	US
Telephone Number	:	662-843-2721
Fax Number	:

Provider Business Practice Location Address
First Line	:	803 1ST ST
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2309
Country	:	US
Telephone Number	:	662-843-2721
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JERRY ADAMS
Credential	:
Telephone Number	:	662-459-7000

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	02/05/2008

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Directions to “GREENWOOD LEFLORE HOSPITAL ” Practice Location

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