Healthcare Provider Details

I. General information

NPI: 1275621211
Provider Name (Legal Business Name): NESHOBA COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 E MAIN ST SUITE 4
PHILADELPHIA MS
39350-2348
US

IV. Provider business mailing address

1122 E MAIN ST SUITE 4
PHILADELPHIA MS
39350-2348
US

V. Phone/Fax

Practice location:
  • Phone: 601-656-1001
  • Fax: 601-656-7555
Mailing address:
  • Phone: 601-656-1001
  • Fax: 601-656-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMS

VIII. Authorized Official

Name: PAULA CLEARMAN
Title or Position: OFFICE MANAGER
Credential: F.N.P.
Phone: 601-656-1001