Organization
SOUTH SUNFLOWER COUNTY HOSPITAL
Active
Other names
Indianola Family Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM WOODS (CLINIC ADMINISTRATOR)
(662) 887-2212
Entity
Organization
Contact information
Practice address
122 E BAKER ST, INDIANOLA, MS 38751-2451
(662) 887-2212
(662) 887-1279
Mailing address
122 E BAKER ST, INDIANOLA, MS 38751-2451
(662) 887-2212
(662) 887-1279
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08904503
—
MS
05
—
09015873
—
MS
Enumeration date
08/03/2006
Last updated
08/22/2020
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