Provider Demographics
NPI:1558565499
Name:THE UNIVERSITY OF MISSISSIPPI SPEECH AND HEARING CENTER
Entity Type:Organization
Organization Name:THE UNIVERSITY OF MISSISSIPPI SPEECH AND HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL RECORDS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-915-7950
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY
Mailing Address - State:MS
Mailing Address - Zip Code:38677-1848
Mailing Address - Country:US
Mailing Address - Phone:662-915-7271
Mailing Address - Fax:662-915-7263
Practice Address - Street 1:2301 SOUTH LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-915-7271
Practice Address - Fax:662-915-7263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS9016064Medicaid