Organization
SOUTHERN HEALTHCARE PROVIDERS
Active
Other names
N W MISSISSIPPI SPECIALTY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODERICK C GIVENS M.D. (PRESIDENT)
(770) 429-1411
Entity
Organization
Contact information
Practice address
1401 RIVER RD, GREENWOOD, MS 38930-4030
(770) 429-1411
(770) 429-1951
Mailing address
PO BOX 18394, NATCHEZ, MS 39122-8394
(770) 429-1411
(770) 429-1951
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
14914
MS
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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