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General NPI Number Information
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NPI Number | 1154310514
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Entity Type | Organization
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Legal Business Name | OKTIBBEHA COUNTY HOSPITAL
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 400 HOSPITAL RD
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City | STARKVILLE
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State | MS
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Zip | 39759-2163
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Country | US
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Telephone | 662-615-2503
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Fax | 662-615-2554
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Provider Business Mailing Address
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Address Line | 400 HOSPITAL RD
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City | STARKVILLE
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State | MS
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Zip | 39759-2163
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Country | US
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Telephone | 662-615-2503
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Fax | 662-615-2554
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES H. JACKSON JR.
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Credential |
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Telephone | 662-615-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 11-269
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License Number State | MS
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