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NPI Code Detail

MEDICARE: LAIRD HOSPITAL, INC.

MEDICARE: LAIRD HOSPITAL, INC.
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
1207Q00000XFamily Medicine Physician
2363LF0000XFamily Nurse Practitioner
3261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851643928
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAIRD HOSPITAL, INC.
Provider Business Mailing Address
First Line : DEPT. 3023 PO BOX 1000
Second Line :
City : MEMPHIS
State : TN
Zip : 38148-3023
Country : US
Telephone Number : 601-213-3010
Fax Number : 601-213-3011
Provider Business Practice Location Address
First Line : 24345 HIGHWAY 15
Second Line :
City : UNION
State : MS
Zip : 39365-8575
Country : US
Telephone Number : 601-774-8211
Fax Number : 601-774-8589
Authorized Official
Title or Position : REGIONAL CEO
Name : DON LARKIN KENNEDY
Credential :
Telephone Number : 601-703-9614
Provider Enumeration Date : 10/12/2012
Last Update Date : 04/26/2023

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Directions to “LAIRD HOSPITAL, INC. ” Practice Location

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