Medical Foundation of Central Mississippi
Organization Active NPI Cardiovascular Disease Physician · Koscuisko, MS
NPI 1891022547 · NPPES record last updated Nov 17, 2009
Key facts
- NPI
- 1891022547
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
- Practice address
- 329 Highway 12 West
Koscuisko, MS 39090 - Phone
- (601) 292-4261
- Fax
- (601) 292-4262
- NPI assigned
- Nov 17, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
Authorized official
- Name
- Mrs. Elizabeth Mullins
- Title
- Director Clinic Operations
- Phone
- (601) 292-4261
Corporate family (same tax ID) 41
National Provider Directory
- Tax ID family
- Baptist PT - Northtown
- Part of
- Baptist PT - Northtown
Locations
329 Hwy 12 W
Koscuisko, MS 39090
Phone (601) 292-4261
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
329 Highway 12 West
Koscuisko, MS 39090
Mailing address
1151 N State St
Suite 504
Jackson, MS 39202-2407
Phone (601) 292-4261
Other names
- Baptist Medical Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.