Organization
CLARKSDALE HMA LLC
Active
Other names
Clarksdale Phys Serv Anesthesia CRNA
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES)
(615) 778-8074
Entity
Organization
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 624-3401
Mailing address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 624-3401
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000019315A
BC CRNA
MS
05
—
090114363
—
MS
Enumeration date
07/12/2006
Last updated
05/23/2019
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