Healthcare Provider Details

I. General information

NPI: 1013348077
Provider Name (Legal Business Name): NORTH MISSISSIPPI MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 12/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S GLOSTER ST 4TH FLOOR EAST TOWER
TUPELO MS
38801-4934
US

IV. Provider business mailing address

830 S GLOSTER ST 4TH FLOOR EAST TOWER
TUPELO MS
38801-4934
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-7170
  • Fax: 662-377-2423
Mailing address:
  • Phone: 662-377-7170
  • Fax: 662-377-2423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH REPPERT
Title or Position: VP/CFO
Credential:
Phone: 662-377-3978