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General NPI Number Information
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NPI Number | 1649748252
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Entity Type | Organization
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Legal Business Name | ORTHO EXPRESS HOLDING COMPANY LLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2601 GETWELL RD STE 4
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City | CORINTH
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State | MS
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Zip | 38834-6762
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Country | US
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Telephone | 662-643-4533
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Fax | 662-534-2330
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Provider Business Mailing Address
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Address Line | 2601 GETWELL RD STE 4
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City | CORINTH
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State | MS
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Zip | 38834-6762
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Country | US
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Telephone | 662-534-2227
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Fax | 662-534-2330
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER C BULLOCK
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Credential |
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Telephone | 662-534-2298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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