NPIMap

Organization Active NPI

Surgery Clinic of Tupelo PA

  • Surgery Physician
  • Hamilton, AL
National Provider Identifier
1023589017
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGERY CLINIC OF TUPELO PA
Practice address
1256 Military St S
Hamilton, AL 35570-5003
Phone
(205) 921-6202
NPI assigned
Dec 17, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terecia Spain
Title
Clinic Administrator
Phone
(662) 377-6472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1256 Military St S
Hamilton, AL 35570-5003

Mailing address

499 Gloster Creek VLG Ste S1
Tupelo, MS 38801-4708
Phone (662) 377-6470

National Provider Directory

National Provider Directory

Locations

4381 S Eason Blvd
Ste 202
Tupelo, MS 38801
Phone (662) 377-6470

499 Gloster Creek Vlg
Ste S1
Tupelo, MS 38801
Phone (662) 377-6470

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1023589017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE S1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014708",
            "telephone_number": "662-377-6470",
            "fax_number": "662-377-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 MILITARY ST S",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355705003",
            "telephone_number": "205-921-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CLINIC OF TUPELO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "SPAIN",
        "authorized_official_first_name": "TERECIA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "662-377-6472"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.