# NORTHWEST MISS REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NWMRMC OPT Clinics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598458515
- **Authorized official:** LORIE TILL (CEO)
- **Authorized official phone:** (662) 624-3480

## Contact information

- **Practice address:** 1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
- **Practice address phone:** (662) 627-3211
- **Practice address fax:** (662) 624-3413
- **Mailing address:** PO BOX 1218, CLARKSDALE, MS 38614-1218
- **Mailing address phone:** (662) 627-3211
- **Mailing address fax:** (662) 624-3214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 05/26/2023
- **Last updated:** 01/21/2025