# CLARKSDALE HMA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clarksdale Phys Serv Anesthesia CRNA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386679744
- **Authorized official:** JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES)
- **Authorized official phone:** (615) 778-8074

## Contact information

- **Practice address:** 1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
- **Practice address phone:** (662) 624-3401
- **Mailing address:** 1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
- **Mailing address phone:** (662) 624-3401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 05/23/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000019315A | BC CRNA | MS |
| 05 | — | 090114363 | — | MS |