# MAGNOLIA REGIONAL COMMUNITY CARE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAGNOLIA REGIONAL HEALTH CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639338577
- **Legal business name:** MAGNOLIA REGIONAL HEALTH CENTER
- **Authorized official:** MR. HOWARD D. NELSON (VP PHYSICAIN SERVICES)
- **Authorized official phone:** (662) 293-7618

## Contact information

- **Practice address:** 703 ALCOM DRIVE, 109, CORINTH, MS 38834-9302
- **Practice address phone:** (662) 293-1680
- **Practice address fax:** (662) 293-1595
- **Mailing address:** 401 ALCORN DR STE 2C, CORINTH, MS 38834-9073
- **Mailing address phone:** (662) 293-7618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2008
- **Last updated:** 05/14/2021