Provider Demographics
NPI:1265683775
Name:CLAY COUNTY MEDICAL
Entity Type:Organization
Organization Name:CLAY COUNTY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED REGISTERED NURSE ANESTHET
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:SINCLAIR
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-324-2639
Mailing Address - Street 1:835 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-9320
Mailing Address - Country:US
Mailing Address - Phone:662-495-2300
Mailing Address - Fax:662-495-2262
Practice Address - Street 1:835 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9320
Practice Address - Country:US
Practice Address - Phone:662-495-2300
Practice Address - Fax:662-495-2262
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR869946282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural