# WAYNE GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAYNE GENERAL HOSPITAL
- **Other names:** WAYNE GENERAL EEG
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720203367
- **Legal business name:** WAYNE GENERAL HOSPITAL
- **Authorized official:** MRS. KATHY WADDELL (ADMINISTRATOR)
- **Authorized official phone:** (601) 735-5151

## Contact information

- **Practice address:** 950 MATTHEW DR, WAYNESBORO, MS 39367-2567
- **Practice address phone:** (601) 735-5151
- **Practice address fax:** (601) 735-7168
- **Mailing address:** 950 MATTHEW DR, P O BOX 1249, WAYNESBORO, MS 39367-2567
- **Mailing address phone:** (601) 735-5151
- **Mailing address fax:** (601) 735-7168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 11-288 | MS | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 05/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09013098 | — | MS |