Organization
CHOCTAW REGIONAL MEDICAL CENTER
Active
Other names
Choctaw Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN HOLLINGSWORTH WELLS (ADMINISTRATOR)
(662) 285-9460
Entity
Organization
Contact information
Practice address
8613 MS HIGHWAY 12, ACKERMAN, MS 39735-8917
(662) 285-4400
Mailing address
8613 MS HWY 12 CAMPUS CLINIC SUITE B, ACKERMAN, MS 39735-0719
(662) 285-9460
(662) 285-9324
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04477821
—
MS
Enumeration date
07/18/2014
Last updated
05/03/2022
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