Healthcare Provider Details

I. General information

NPI: 1861723652
Provider Name (Legal Business Name): BAPTIST MEMORIAL HEALTH SERVICES INC OF MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 S LAMAR BLVD SUITE 100
OXFORD MS
38655-5373
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-0119
  • Fax: 662-513-9673
Mailing address:
  • Phone: 901-227-7463
  • Fax: 901-227-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD R POUNDS
Title or Position: CFO SENIOR VICE PRESIDENT
Credential:
Phone: 901-227-7463