Organization
MISSISSIPPI STATE HOSPITAL AT WHITFIELD
Active
Parent organization
MISSISSIPPI STATE HOSPITAL AT WHITFIELD
Other names
Oak Circle Center Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI STATE HOSPITAL AT WHITFIELD
Authorized official
MR. JAMES G CHASTAIN (DIRECTOR)
(601) 351-8000
Entity
Organization
Contact information
Practice address
3550 HWY 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8586
Mailing address
P.O. BOX 1 FISCAL SERVICES, 3550 HWY 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8586
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31-320
MS
1223G0001X
General Practice Dentistry
31-320
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014445
—
MS
Enumeration date
10/04/2006
Last updated
05/05/2017
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