Organization
MAGNOLIA SURGICAL GROUP
Active
Parent organization
MAGNOLIA REGIONAL HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGNOLIA REGIONAL HEALTH CENTER
Authorized official
MR. HOWARD NELSON (VP PHYSICIAN SERVICES)
(662) 293-7618
Entity
Organization
Contact information
Practice address
703 ALCORN DRIVE, 102, CORINTH, MS 38834-9323
(662) 286-2522
(662) 293-4288
Mailing address
P.O. BOX 2040, CORINTH, MS 38835-9302
(662) 286-2522
(662) 293-4288
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
05438
MS
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06486235
—
MS
Enumeration date
07/26/2006
Last updated
01/25/2019
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