Healthcare Provider Details

I. General information

NPI: 1275081754
Provider Name (Legal Business Name): NORTH MISSISSIPPI ELECTROPHYSIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 GLOSTER CREEK VILLAGE SUITE A-2
TUPELO MS
38801-4749
US

IV. Provider business mailing address

808 VARSITY DR
TUPELO MS
38801-4613
US

V. Phone/Fax

Practice location:
  • Phone: 662-620-6800
  • Fax:
Mailing address:
  • Phone: 662-377-3204
  • Fax: 662-377-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE TOPPIN
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 662-377-3000