Provider Demographics
NPI:1902833056
Name:NATCHEZ REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:NATCHEZ REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WESSELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:601-443-2600
Mailing Address - Street 1:54 SEARGENT S PRENTISS DR
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120
Mailing Address - Country:US
Mailing Address - Phone:601-443-2100
Mailing Address - Fax:601-443-2885
Practice Address - Street 1:54 SEARGENT S PRENTISS DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-443-2100
Practice Address - Fax:601-443-2885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATCHEZ REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-26
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11220273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS25S084Medicare ID - Type Unspecified