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Organization
PANOLA PHYSICIAN GROUP, LLC
Active
Organization
PANOLA PHYSICIAN GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY SMITH (ASSOCIATE CHIEF EXECUTIVE OFFICER)
(817) 253-7630
Entity
Organization
Contact information
Practice address
255 MEDICAL CENTER DRIVE, BATESVILLE, MS 38606
(662) 563-5611
Mailing address
303 MEDICAL CENTER DR, BATESVILLE, MS 38606-8608
(662) 563-5611
(662) 563-0155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
07/07/2026
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