# MAGNOLIA FAMILY MEDICAL PRACTICE

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

## Provider details

- **NPI number:** 1669991337
- **Legal business name:** MAGNOLIA REGIONAL HEALTH CENTER
- **Authorized official:** RONNY HUMES (CEO)
- **Authorized official phone:** (662) 293-7664

## Contact information

- **Practice address:** 121 PRATT DR STE 1A, CORINTH, MS 38834-6026
- **Practice address phone:** (662) 286-0088
- **Practice address fax:** (662) 286-0067
- **Mailing address:** 401 ALCORN DR STE 2C, CORINTH, MS 38834-9073
- **Mailing address phone:** (662) 293-7266
- **Mailing address fax:** (662) 293-6255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/14/2017
- **Last updated:** 09/14/2017