Organization
MAGNOLIA GASTROENTEROLOGY CLINIC, LLC
Active
Other names
Corinth Gastroenterology Clinic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRICK ALVIN CORDER M.D. (OWNER/PHYSICIAN/MEDICAL DIRECTOR)
(662) 284-9902
Entity
Organization
Contact information
Practice address
3050 CORDER DRIVE, MAGNOLIA GASTROENTEROLOGY CLINIC, LLC, CORINTH, MS 38834
(662) 284-9902
(662) 284-9904
Mailing address
PO BOX 600, CORINTH, MS 38835-0600
(662) 284-9902
(662) 284-9904
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016046
—
MS
Enumeration date
12/01/2005
Last updated
08/22/2020
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