Magnolia Internal Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16638 Issued in MS

Legal business name

MAGNOLIA INTERNAL MEDICAL CLINIC

Practice address

5 River Bend PL
Suite C
Flowood, MS 39232-7618

Phone

(601) 933-9696

NPI assigned

Aug 21, 2006

Last updated

Jul 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Evan L. Summers, M,D,NPI 1922074384

Title

President

Phone

(601) 933-9696

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Evan L. Summers, DO

  • Hospitalist Physician
  • Oxford, MS
  • NPI 1922074384

  Internal Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1467567990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321411",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321411",
            "telephone_number": "601-933-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RIVER BEND PL",
            "address_2": "SUITE C",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327618",
            "telephone_number": "601-933-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA INTERNAL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-933-9696",
        "authorized_official_credential": "M,D,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06923312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sudhakar Madakasira
• John B Madden, M.D.
• Madison Physician Surgery Center, LLC (The Surgery Center at Mississippi Sports Medicine)
• Magnolia Anesthesia Consultants LLC
• Magnolia Elite Wellness Group LLC
• Magnolia Neurology Clinic
• Madison Mahaffey, OT
• Tonya Powell Malone, R.N.F.A.
• Jacob Byron Maloney, FNP-C
• Dametra Mangum, FNP

• Internal Medicine Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.