# NORTH MISSISSIPPI ANESTHESIA, LLC

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

## Provider details

- **NPI number:** 1871058792
- **Authorized official:** ROBERT E MCCARVILLE (ADMINISTRATOR)
- **Authorized official phone:** (662) 432-1490

## Contact information

- **Practice address:** 1211 S GLOSTER ST STE B, TUPELO, MS 38801-6535
- **Practice address phone:** (662) 266-1670
- **Mailing address:** 2808 S INGRAM MILL RD BLDG B, SPRINGFIELD, MO 65804-4017
- **Mailing address phone:** (417) 889-2040
- **Mailing address fax:** (417) 719-7896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 02/05/2019
- **Last updated:** 02/21/2020