Provider Demographics
NPI:1235235631
Name:BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Entity Type:Organization
Organization Name:BAPTIST MEMORIAL HEALTH SERVICES, INC. OF MISSISSIPPI
Other - Org Name:COLUMBUS RHEUMATOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:POUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-227-7463
Mailing Address - Street 1:255 BAPTIST BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2011
Mailing Address - Country:US
Mailing Address - Phone:662-327-3236
Mailing Address - Fax:662-327-6458
Practice Address - Street 1:255 BAPTIST BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2011
Practice Address - Country:US
Practice Address - Phone:662-327-3236
Practice Address - Fax:662-327-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05071528Medicaid
MS05071528Medicaid
DC4382Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS05071528Medicaid