Healthcare Provider Details

I. General information

NPI: 1871708107
Provider Name (Legal Business Name): CARROLL COUNTY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 MARSHALL RD
N. CARROLLTON MS
38947
US

IV. Provider business mailing address

PO BOX 256
CARROLLTON MS
38917-0256
US

V. Phone/Fax

Practice location:
  • Phone: 662-237-6840
  • Fax: 662-237-0080
Mailing address:
  • Phone: 662-237-9276
  • Fax: 662-237-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR811598
License Number StateMS

VIII. Authorized Official

Name: MR. BILLY JOE FERGUSON
Title or Position: SUPERINTENDENT
Credential:
Phone: 662-237-9276