Magnolia Family Clinic

Organization Active NPI Family Medicine Physician · Corinth, MS

NPI 1104377472 · NPPES record last updated Oct 20, 2016

Key facts

NPI
1104377472
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MAGNOLIA FAMILY CLINIC
Practice address
102 Norman Rd
Corinth, MS 38834-9372
Phone
(662) 293-1000
NPI assigned
Oct 20, 2016
Organization subpart
Yes
Parent organization (as reported)
MAGNOLIA REGIONAL HEALTH CENTER

Authorized official

Name
Ronny Humes
Title
Ceo
Phone
(662) 293-1000

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Magnolia Family Clinic (2 organizations share this tax ID)
Part of
Magnolia Hospital Ekg

Locations

102 Norman Rd
Corinth, MS 38834
Phone (662) 287-8035

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

102 Norman Rd
Corinth, MS 38834-9372

Mailing address

102 Norman Rd
Corinth, MS 38834-9372

Other providers in Corinth, MS

All providers in Corinth, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.