Provider Demographics
NPI:1689074395
Name:NORTH MISSISSIPPI MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI MEDICAL CENTER INC.
Other - Org Name:PEDIATRIC HOSPITALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEGAL SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-3000
Mailing Address - Street 1:830 S GLOSTER ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4934
Mailing Address - Country:US
Mailing Address - Phone:662-377-8852
Mailing Address - Fax:662-377-4907
Practice Address - Street 1:830 S GLOSTER ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4934
Practice Address - Country:US
Practice Address - Phone:662-377-8852
Practice Address - Fax:662-377-4907
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-29
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC03168Medicare PIN