# SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CARDIOVASCULAR INSTITUTE OF MISSISSIPPI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124077581
- **Authorized official:** MRS. CHARLA ROWLEY (CEO)
- **Authorized official phone:** (601) 249-1806

## Contact information

- **Practice address:** 303 MARION AVE, MCCOMB, MS 39648-2707
- **Practice address phone:** (601) 249-1350
- **Practice address fax:** (601) 249-1339
- **Mailing address:** PO BOX 490, MCCOMB, MS 39649-0490
- **Mailing address phone:** (601) 249-2701
- **Mailing address fax:** (601) 249-2195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 11/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09015786 | — | MS |