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NPI Code Detail

MEDICARE: CLARKSDALE HMA

MEDICARE: CLARKSDALE HMA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner
2207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1508984436
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARKSDALE HMA
Provider Business Mailing Address
First Line : 580 FRIARS POINT RD
Second Line :
City : CLARKSDALE
State : MS
Zip : 38614-9734
Country : US
Telephone Number : 662-624-8000
Fax Number : 662-627-2900
Provider Business Practice Location Address
First Line : 785 OHIO AVE
Second Line : SUITE 2F
City : CLARKSDALE
State : MS
Zip : 38614-9734
Country : US
Telephone Number : 662-621-5081
Fax Number : 662-621-5083
Authorized Official
Title or Position : PHYSICIAN PRACTICE MANAGER
Name : MRS. ANN NOWELL
Credential :
Telephone Number : 662-624-8000
Provider Enumeration Date : 03/27/2007
Last Update Date : 09/11/2025

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Directions to “CLARKSDALE HMA ” Practice Location

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