# FORREST COUNTY GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jefferson Davis General Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730452558
- **Authorized official:** RICHARD ANDREW WOODARD (CFO)
- **Authorized official phone:** (601) 288-2892

## Contact information

- **Practice address:** 1102 ROSE ST, PRENTISS, MS 39474-5200
- **Practice address phone:** (601) 792-4276
- **Practice address fax:** (601) 792-2947
- **Mailing address:** 1102 ROSE ST, PRENTISS, MS 39474-5200
- **Mailing address phone:** (601) 792-4276
- **Mailing address fax:** (601) 792-2947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 02/10/2012