MEDICARE: MISSISSIPPI PAIN INSTITUTE CORINTH PLLC

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
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1699639898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSISSIPPI PAIN INSTITUTE CORINTH PLLC

Provider Business Mailing Address
First Line	:	PO BOX 395
Second Line	:
City	:	BATESVILLE
State	:	MS
Zip	:	38606-0395
Country	:	US
Telephone Number	:	662-710-1035
Fax Number	:	662-710-1036

Provider Business Practice Location Address
First Line	:	3037 CORDER DR
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-6216
Country	:	US
Telephone Number	:	662-284-8565
Fax Number	:	662-594-8366

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	STEVEN NAMANNY
Credential	:
Telephone Number	:	769-229-3758

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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