Healthcare Provider Details

I. General information

NPI: 1639345697
Provider Name (Legal Business Name): UHS OF PARKWOOD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 GOODMAN RD
OLIVE BRANCH MS
38654-2103
US

IV. Provider business mailing address

8135 GOODMAN RD
OLIVE BRANCH MS
38654-2103
US

V. Phone/Fax

Practice location:
  • Phone: 662-895-4900
  • Fax:
Mailing address:
  • Phone: 662-895-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-768-3300