Provider Demographics
NPI:1013318898
Name:CLAY COUNTY MEDICAL CORPORATION
Entity Type:Organization
Organization Name:CLAY COUNTY MEDICAL CORPORATION
Other - Org Name:CLAY COUNTY ADVANCED WOUND CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-3978
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:662-495-2128
Mailing Address - Fax:662-495-2361
Practice Address - Street 1:830 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9319
Practice Address - Country:US
Practice Address - Phone:662-495-2128
Practice Address - Fax:662-495-2361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLAY COUNTY MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-11
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center