# MAGNOLIA MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1821257767
- **Legal business name:** MAGNOLIA REGIONAL HEALTH CENTER
- **Authorized official:** MR. RONNY D. HUMES (CEO/ME)
- **Authorized official phone:** (662) 293-7664

## Contact information

- **Practice address:** 502 ALCORN DRIVE, CORINTH, MS 38834-9323
- **Practice address phone:** (662) 287-5216
- **Practice address fax:** (662) 287-8406
- **Mailing address:** P.O. BOX 2040, CORINTH, MS 38835-2040
- **Mailing address phone:** (662) 287-5216
- **Mailing address fax:** (662) 287-8406

## Taxonomy

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

## Other

- **Enumeration date:** 06/05/2008
- **Last updated:** 07/21/2015