Healthcare Provider Details

I. General information

NPI: 1295849578
Provider Name (Legal Business Name): BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 S LAMAR BLVD SUITE 140
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: 662-513-3246
  • Fax: 662-513-6248
Mailing address:
  • Phone: 901-227-7463
  • Fax: 901-227-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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