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General NPI Number Information
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NPI Number | 1356359632
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Entity Type | Organization
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Legal Business Name | ENDOSCOPY CENTER OF NORTH MISSISSIPPI,LLC
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1206 OFFICE PARK DR
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City | OXFORD
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State | MS
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Zip | 38655-3597
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Country | US
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Telephone | 662-236-1768
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Fax | 662-236-9898
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Provider Business Mailing Address
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Address Line | PO BOX 381468
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City | GERMANTOWN
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State | TN
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Zip | 38183-1468
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, CREDENTIALING
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Name | KRISTINA MATERNA
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Credential |
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Telephone | 901-377-8219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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