Organization
PONTOTOC HEALTH PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE TOPPIN (CORPORATE SECRETARY)
(662) 377-4229
Entity
Organization
Contact information
Practice address
808 VARSITY DR, TUPELO, MS 38801-4613
(662) 377-2386
(662) 377-2057
Mailing address
176 S MAIN ST, PONTOTOC, MS 38863-3311
(662) 489-5510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/01/2015
Last updated
01/20/2025
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