Healthcare Provider Details

I. General information

NPI: 1295658037
Provider Name (Legal Business Name): SOUTH SUNFLOWER COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E BAKER ST
INDIANOLA MS
38751-2450
US

IV. Provider business mailing address

121 E BAKER ST
INDIANOLA MS
38751-2450
US

V. Phone/Fax

Practice location:
  • Phone: 662-635-7200
  • Fax:
Mailing address:
  • Phone: 662-635-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY PHILLIPS
Title or Position: CEO
Credential:
Phone: 662-635-7200