Healthcare Provider Details

I. General information

NPI: 1689671588
Provider Name (Legal Business Name): NORTH MISSISSIPPI HEMATOLOGY & ONCOLOGY ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

961 SOUTH GLOSTER STREET
TUPELO MS
38801-6343
US

IV. Provider business mailing address

961 SOUTH GLOSTER STREET
TUPELO MS
38801-6343
US

V. Phone/Fax

Practice location:
  • Phone: 662-844-9166
  • Fax:
Mailing address:
  • Phone: 662-844-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number08548
License Number StateMS

VIII. Authorized Official

Name: JULIAN B HILL
Title or Position: PRESIDENT
Credential: MD
Phone: 662-844-9166