North Central Mississippi Regional Cancer Center

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

07161 Issued in MS

Legal business name

NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER

Practice address

1401 River Rd
Greenwood, MS 38930-4030

Phone

(662) 459-7133

Fax

(662) 459-7136

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Madison Wilson Gaillard III

Title

Administrator

Phone

(662) 459-7133

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275645798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-7133",
            "fax_number": "662-459-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-7133",
            "fax_number": "662-459-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAILLARD",
        "authorized_official_first_name": "MADISON",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-459-7133",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "07161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9014280",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Covenant Hospice II, LLC
• New Haven Chiropractic Clinic, LLC
• New Horizon Adult Day Care
• Nexion Health at Greenwood, Inc.
• Nhis Care
• North Florida Radiological Institute Inc
• North Sunflower Medical Center
• North Sunflower Medical Center
• North Sunflower Medical Center
• North Sunflower Medical Center

• Radiation Oncology Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Radiation Oncology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.