Provider Demographics
NPI:1497091730
Name:NORTH MISSISSIPPI MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI MEDICAL CENTER, INC
Other - Org Name:NORTH MISSISSIPPI REGIONAL PAIN CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:REPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-3978
Mailing Address - Street 1:4381 S EASON BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6583
Mailing Address - Country:US
Mailing Address - Phone:662-377-5199
Mailing Address - Fax:662-377-5301
Practice Address - Street 1:4381 S EASON BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6583
Practice Address - Country:US
Practice Address - Phone:662-377-5199
Practice Address - Fax:662-377-5301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty