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General NPI Number Information
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NPI Number | 1487819934
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Entity Type | Organization
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Legal Business Name | MAGEE BENEVOLENT ASSOCIATION D/B/A MAGEE GENERAL HOSPITAL
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 376A SIMPSON HIGHWAY 149
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City | MAGEE
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State | MS
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Zip | 39111-3409
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Country | US
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Telephone | 601-849-5321
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Fax | 601-849-7205
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Provider Business Mailing Address
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Address Line | 376A SIMPSON HIGHWAY 149
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City | MAGEE
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State | MS
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Zip | 39111-3409
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Country | US
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Telephone | 601-849-5321
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Fax | 601-849-7205
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Authorized Official
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Title or Position | C E O
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Name | MRS. ALTHEA H CRUMPTON
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Credential |
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Telephone | 601-849-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA00024
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R678562
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License Number State | MS
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