Organization · Type 2 NPI

Mississippi Band of Choctaw Indians

Federal Public Health Clinic/Center · Conehatta, MS

NPI number 1013092600 Active

Practice location

376 Campus Rd
Conehatta, MS 39057-2800

Call (601) 656-2211 Map

Fax (601) 663-7721

Mailing address

210 Hospital Cir
Choctaw, MS 39350-6781

Specialties and licenses

Taxonomy	Code	License
Federal Public Health Clinic/Center Primary	261QP0904X	None listed

Federal Public Health Clinic/Center: Definition to come...

NPI record

NPI: 1013092600
Entity type: Organization (Type 2)
Issued: Oct 25, 2006
Last updated: Jun 15, 2012
Status: Active
Subpart: Yes of Mississippi Band of Choctaw Indians

Other names

<unavail>
Conehatta Satellite Clinic · doing business as

Authorized official

Mrs. Phyllils J Anderson
Tribal Chief
(601) 656-2211

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1013092600

Mississippi Band of Choctaw Indians's National Provider Identifier is 1013092600, issued on Oct 25, 2006. The primary taxonomy on file is Federal Public Health Clinic/Center (261QP0904X), and the practice location is in Conehatta, MS. The record was last updated on Jun 15, 2012.