Organization · Type 2 NPI

Medical Foundation of Central Mississippi

Cardiovascular Disease Physician · Koscuisko, MS

NPI number 1891022547 Active

Practice location

329 Highway 12 West
Koscuisko, MS 39090

Call (601) 292-4261 Map

Fax (601) 292-4262

Mailing address

1151 N State St, Suite 504
Jackson, MS 39202-2407

Specialties and licenses

Taxonomy	Code	License
Cardiovascular Disease Physician Primary	207RC0000X	None listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

NPI record

NPI: 1891022547
Entity type: Organization (Type 2)
Issued: Nov 17, 2009
Last updated: Nov 17, 2009
Status: Active
Subpart: Yes of Medical Foundation of Central Mississippi

Other names

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Baptist Medical Clinic · doing business as

Authorized official

Mrs. Elizabeth Mullins
Director Clinic Operations
(601) 292-4261

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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.

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About NPI 1891022547

Medical Foundation of Central Mississippi's National Provider Identifier is 1891022547, issued on Nov 17, 2009. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Koscuisko, MS. The record was last updated on Nov 17, 2009.