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General NPI Number Information
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NPI Number | 1992024558
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Entity Type | Organization
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Legal Business Name | SOUTH PIKE HOSPITAL ASSOCIATION, INC
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 1081 SECOND ST
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City | OSYKA
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State | MS
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Zip | 39657-8076
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Country | US
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Telephone | 601-542-3300
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Fax | 601-542-5999
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Provider Business Mailing Address
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Address Line | PO BOX 351
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City | MAGNOLIA
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State | MS
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Zip | 39652-0351
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Country | US
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Telephone | 601-783-2353
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Fax | 601-783-9003
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MR. GUY C. GELLER
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Credential |
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Telephone | 601-783-2353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 16-275
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License Number State | MS
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