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Organization

COPIAH COUNTY MEDICAL CENTER

Active
Parent organization
COPIAH COUNTY MEDICAL CENTER
Other names
Hazlehurst Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
COPIAH COUNTY MEDICAL CENTER
Authorized official
KORTNEY M. GADDY (CFO)
(601) 574-7200
Entity
Organization

Contact information

Practice address
213 CALDWELL DR, HAZLEHURST, MS 39083
(601) 894-2514
(601) 894-2514
Mailing address
27190 HWY 28, HAZLEHURST, MS 39083
(601) 574-7200
(601) 894-2514

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00011981
MS
05
00012939
MS
05
00015329
MS
05
00113908
MS
05
00116996
MS
05
00119484
MS
05
00122024
MS
05
09013707
MS
Enumeration date
09/20/2006
Last updated
09/22/2022
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