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General NPI Number Information
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NPI Number | 1255650321
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Entity Type | Organization
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Legal Business Name | NESHOBA COUNTY GENERAL HOSPITAL
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 110 PARK ST
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City | WALNUT GROVE
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State | MS
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Zip | 39189-6526
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Country | US
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Telephone | 601-253-0173
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Fax | 601-253-0176
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Provider Business Mailing Address
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Address Line | 110 PARK ST
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City | WALNUT GROVE
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State | MS
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Zip | 39189-6526
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Country | US
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Telephone | 601-253-0173
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Fax | 601-253-0176
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT
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Name | MRS. CHERYL L SAVELL
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Credential |
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Telephone | 601-389-1563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12146
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License Number State | MS
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