Organization
NORTH MISSISSIPPI SPINE CENTER, INC
Active
Other names
North Mississippi Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRIDGETTE ROCKETTE HARMON RN, BSN (MANAGER OF CLINICAL SERVICES)
(662) 563-7728
Entity
Organization
Contact information
Practice address
109 EUREKA STREET, SUITE B, BATESVILLE, MS 38606
(662) 563-7728
(662) 563-4888
Mailing address
PO BOX 1204, OXFORD, MS 38655-1204
(662) 563-7728
(662) 563-4888
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
25C0001060
MS
293D00000X
Physiological Laboratory
542011
MS
335E00000X
Prosthetic/Orthotic Supplier
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015663
—
MS
05
—
00122658
—
MS
05
—
04584863
—
MS
05
—
05001777
—
MS
05
—
05621095
—
MS
01
—
5521760001
NSCSSUPP DMEPOS
MS
Enumeration date
09/29/2006
Last updated
04/24/2013
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