Provider Demographics
NPI:1770690174
Name:CLAY COUNTY MEDICAL CORPORATION
Entity type:Organization
Organization Name:CLAY COUNTY MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
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:662-377-4229
Mailing Address - Street 1:808 VARSITY DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4613
Mailing Address - Country:US
Mailing Address - Phone:662-377-3204
Mailing Address - Fax:662-377-2057
Practice Address - Street 1:150 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-0428
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:2006-08-23
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13-312275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
25U067Medicare Oscar/Certification