=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992604490
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RH EMERGENCY MEDICINE OF COPIAH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2026
-----------------------------------------------------
Last Update Date | 11/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27190 HIGHWAY 28
-----------------------------------------------------
City | HAZLEHURST
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39083-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-432-4106
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7058
-----------------------------------------------------
City | TUPELO
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38802-7058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-432-4106
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ENTERPRISE CFO
-----------------------------------------------------
Name | JENNIFER K WAKEFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 205-901-5103
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------