# SOUTHERN HEALTHCARE PROVIDERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** N W MISSISSIPPI SPECIALTY CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568660744
- **Authorized official:** DR. RODERICK C GIVENS M.D. (PRESIDENT)
- **Authorized official phone:** (770) 429-1411

## Contact information

- **Practice address:** 1401 RIVER RD, GREENWOOD, MS 38930-4030
- **Practice address phone:** (770) 429-1411
- **Practice address fax:** (770) 429-1951
- **Mailing address:** PO BOX 18394, NATCHEZ, MS 39122-8394
- **Mailing address phone:** (770) 429-1411
- **Mailing address fax:** (770) 429-1951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 170100000X | Ph.D. Medical Genetics | 14914 | MS | Yes |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 07/10/2007