Organization
RUSH MEDICAL FOUNDATION
Active
Other names
Ochsner Health Center-Quitman
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON LARKIN KENNEDY (REGIONAL CEO)
(601) 703-9614
Entity
Organization
Contact information
Practice address
603 S ARCHUSA AVE, QUITMAN, MS 39355-2331
(601) 776-2123
(601) 776-6006
Mailing address
DEPT 3027, P O BOX 1000, MEMPHIS, TN 38148-3027
(601) 213-3010
(601) 213-3011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009016210
—
MS
Enumeration date
09/27/2012
Last updated
04/26/2023
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