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NPI 1710352356

NPI 1710352356 : ANDERSON REGIONAL MEDICAL CENTER : MERIDIAN, MS

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General NPI Number Information
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    NPI Number           |    1710352356
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANDERSON REGIONAL MEDICAL CENTER 
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Dates
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    Enumeration Date     |    12/08/2015
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    Last Update Date     |    08/16/2024
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Provider Practice Location Address
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    Address Line         |    1523 22ND AVE STE B 
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    City                 |    MERIDIAN
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    State                |    MS
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    Zip                  |    39301-4016
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    Country              |    US
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    Telephone            |    601-703-8450
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    Fax                  |    601-703-8459
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Provider Business Mailing Address
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    Address Line         |    2124 14TH ST 
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    City                 |    MERIDIAN
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    State                |    MS
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    Zip                  |    39301-4040
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    Country              |    US
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    Telephone            |    601-703-3480
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    Fax                  |    601-703-0124
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Authorized Official
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    Title or Position    |    SR VP / CLO
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    Name                 |     GREGORY M DUCKETT 
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    Credential           |    
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    Telephone            |    901-227-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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