Organization
TISHOMINGO REGIONAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH REPPERT (VP/CFO)
(662) 377-3978
Entity
Organization
Contact information
Practice address
465 2ND STREET, BELMONT, MS 38827-0000
(662) 377-4685
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19791
MS
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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