Healthcare Provider Details

I. General information

NPI: 1811135254
Provider Name (Legal Business Name): BATESVILLE HOSPITAL MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 EUREKA ST SUITE A
BATESVILLE MS
38606-2533
US

IV. Provider business mailing address

314 WESTMORELAND CIR
BATESVILLE MS
38606-8456
US

V. Phone/Fax

Practice location:
  • Phone: 662-561-0800
  • Fax: 662-561-0811
Mailing address:
  • Phone: 601-573-0386
  • Fax: 662-563-2183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12101
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12101
License Number StateMS

VIII. Authorized Official

Name: MRS. MISSY CORKERN
Title or Position: VICE PRESIDENT
Credential: RN
Phone: 601-573-0386