# MIZELL MEMORIAL HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760728455
- **Authorized official:** JANA WYATT (CEO)
- **Authorized official phone:** (334) 493-9111

## Contact information

- **Practice address:** 802 N MAIN ST, OPP, AL 36467-1614
- **Practice address phone:** (334) 493-3240
- **Practice address fax:** (334) 493-9535
- **Mailing address:** PO BOX 1010, OPP, AL 36467-1010
- **Mailing address phone:** (334) 493-3541
- **Mailing address fax:** (334) 493-9664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/27/2012
- **Last updated:** 01/14/2021