Healthcare Provider Details

I. General information

NPI: 1215863113
Provider Name (Legal Business Name): RH HOSPITALIST MEDICINE OF MAGNOLIA REGIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ALCORN DR
CORINTH MS
38834-9368
US

IV. Provider business mailing address

PO BOX 7058
TUPELO MS
38802-7058
US

V. Phone/Fax

Practice location:
  • Phone: 662-432-4106
  • Fax:
Mailing address:
  • Phone: 662-432-4106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER K WAKEFORD
Title or Position: ENTERPRISE CFO
Credential:
Phone: 205-901-5103