NPIMap

Organization Active NPI

Natchez Regional Clinic

  • Family Medicine Physician
  • Vidalia, LA
National Provider Identifier
1780868760
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD200671 Issued in LA
Legal business name
NATCHEZ REGIONAL CLINIC
Practice address
1806 Carter St
Vidalia, LA 71373-3115
Phone
(318) 336-8166
NPI assigned
Dec 26, 2007
Last updated
Dec 26, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
NATCHEZ REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
Gary Mullins
Title
Administrator
Phone
(601) 431-5554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD200671 LA Primary

Addresses

Primary practice location

1806 Carter St
Vidalia, LA 71373-3115

Mailing address

PO Box 14149
Baton Rouge, LA 70898-4149
Phone (225) 924-9827

National Provider Directory

National Provider Directory
Tax ID family
Natchez Regional Clinic2 organizations share this tax ID, including this one
Part of
Natchez Thoracicvascular and Surgery Clinic

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1780868760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14149",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708984149",
            "telephone_number": "225-924-9827",
            "fax_number": "225-924-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 CARTER ST",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733115",
            "telephone_number": "318-336-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATCHEZ REGIONAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATCHEZ REGIONAL MEDICAL CENTER",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-431-5554"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD200671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.