# MAGNOLIA PHYSICIAN SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073827549
- **Authorized official:** MR. HOWARD D. NELSON (VP PHYSICIAN SERVICES)
- **Authorized official phone:** (662) 293-7649

## Contact information

- **Practice address:** 611 ALCORN DR, CORINTH, MS 38834-9321
- **Practice address phone:** (662) 293-7618
- **Mailing address:** PO BOX 2040, CORINTH, MS 38835-2040
- **Mailing address phone:** (662) 287-6913
- **Mailing address fax:** (662) 287-2823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 01/23/2019