Healthcare Provider Details
I. General information
NPI: 1619238961
Provider Name (Legal Business Name): NORTH MISSISSIPPI MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2012
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
735 MEDICAL CENTER DR
WEST POINT MS
39773-9318
US
IV. Provider business mailing address
735 MEDICAL CENTER DR
WEST POINT MS
39773-9318
US
V. Phone/Fax
- Phone: 662-377-2395
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRUCE
TOPPIN
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 662-377-3000