Organization
MIDSOUTH SPINE AND PAIN ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT A GRIMES NP-C (NP-C/PARTNER)
(662) 284-8565
Entity
Organization
Contact information
Practice address
3037 CORDER DR, CORINTH, MS 38834-6216
(662) 284-8565
(662) 594-8366
Mailing address
PO BOX 1740, CORINTH, MS 38835-1740
(662) 284-8565
(662) 594-8366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14758
MS
363LA2100X
Acute Care Nurse Practitioner
701122
MS
363LF0000X
Family Nurse Practitioner
16792
MS
Other
Enumeration date
09/08/2016
Last updated
06/27/2023
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