Healthcare Provider Details

I. General information

NPI: 1730361973
Provider Name (Legal Business Name): NATCHEZ REGIONAL ER PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SEARGENT S PRENTISS DR
NATCHEZ MS
39120-4726
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-1417
US

V. Phone/Fax

Practice location:
  • Phone: 601-443-2166
  • Fax:
Mailing address:
  • Phone: 904-482-1070
  • Fax: 904-482-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL ANDERSON
Title or Position: CFO
Credential:
Phone: 601-443-2796