Healthcare Provider Details

I. General information

NPI: 1841118460
Provider Name (Legal Business Name): COPIAH COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27190 HIGHWAY 28
HAZLEHURST MS
39083-2200
US

IV. Provider business mailing address

27190 HIGHWAY 28
HAZLEHURST MS
39083-2200
US

V. Phone/Fax

Practice location:
  • Phone: 601-574-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KORTNEY MICHELE GADDY
Title or Position: CFO
Credential:
Phone: 601-574-7200