Organization
GREENWOOD LEFLORE HOSPITAL
Active
Other names
North Central MS Neurological Surgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAWNE HOLMES (CFO)
(662) 459-7119
Entity
Organization
Contact information
Practice address
405 RIVER RD, GREENWOOD, MS 38930
(662) 451-7812
Mailing address
PO BOX 1410, GREENWOOD, MS 38935-1410
(662) 459-7189
(662) 451-7812
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05683064
—
MS
01
—
DE4415
MEDICARE RAILROAD
MS
Enumeration date
03/23/2006
Last updated
07/02/2018
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