Provider Demographics
NPI:1033460878
Name:LAIRD HOSPITAL, INC.
Entity Type:Organization
Organization Name:LAIRD HOSPITAL, INC.
Other - Org Name:OCHSNER HEALTH CENTER- DECATUR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:LARKIN
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-703-9614
Mailing Address - Street 1:DEPT. 3023 PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-3023
Mailing Address - Country:US
Mailing Address - Phone:601-213-3010
Mailing Address - Fax:601-703-3011
Practice Address - Street 1:14884 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:MS
Practice Address - Zip Code:39327
Practice Address - Country:US
Practice Address - Phone:601-635-2258
Practice Address - Fax:601-635-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS002276065Medicaid