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NPI Code Detail

MEDICARE: KING'S DAUGHTERS MEDICAL CENTER

MEDICARE: KING'S DAUGHTERS MEDICAL CENTER
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
1341600000XAmbulance
2282N00000XGeneral Acute Care Hospital16235MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CC3386OTHERMSMEDICARE RR-TRAVLERS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000019008OTHERMSPROF SERV KINGS DAUGHTERS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972503464
Entity Type Code : Organization
Provider Name (Legal Business Name) : KING'S DAUGHTERS MEDICAL CENTER
Provider Business Mailing Address
First Line : 427 HIGHWAY 51 N
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2350
Country : US
Telephone Number : 601-833-6011
Fax Number : 601-833-5210
Provider Business Practice Location Address
First Line : 427 HIGHWAY 51 N
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2350
Country : US
Telephone Number : 601-833-6011
Fax Number : 601-833-5210
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : SCOTT CHRISTENSEN
Credential :
Telephone Number : 601-835-9488
Provider Enumeration Date : 07/26/2005
Last Update Date : 04/24/2023

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Directions to “KING'S DAUGHTERS MEDICAL CENTER ” Practice Location

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