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NPI 1790565521

NPI 1790565521 : NORTH MISSISSIPPI MEDICAL CENTER, INC : TUPELO, MS

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General NPI Number Information
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    NPI Number           |    1790565521
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTH MISSISSIPPI MEDICAL CENTER, INC 
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Dates
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    Enumeration Date     |    09/29/2023
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    Last Update Date     |    09/29/2023
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Provider Practice Location Address
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    Address Line         |    2089 SOUTHRIDGE DR 
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    City                 |    TUPELO
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    State                |    MS
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    Zip                  |    38801-6478
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    Country              |    US
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    Telephone            |    662-407-0801
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    Fax                  |    662-407-0807
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Provider Business Mailing Address
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    Address Line         |    808 VARSITY DR 
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    City                 |    TUPELO
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    State                |    MS
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    Zip                  |    38801-4613
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    Country              |    US
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    Telephone            |    662-377-2774
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    Fax                  |    662-377-2057
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Authorized Official
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    Title or Position    |    CORPORATE SECRETARY
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    Name                 |     BRUCE  TOPPIN 
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    Credential           |    
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    Telephone            |    662-377-4229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208VP0000X
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    Taxonomy Name        |    Pain Medicine 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        |    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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