Organization
CLAIBORNE COUNTY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLIE NORRELL (PRESIDENT)
(601) 437-5141
Entity
Organization
Contact information
Practice address
123 MCCOMB AVE, PORT GIBSON, MS 39150-2915
(601) 437-5141
Mailing address
PO BOX 1004, 123 MCCOMB AVENUE, PORT GIBSON, MS 39150-1004
(601) 437-5141
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
26-276
MS
207RC0000X
Cardiovascular Disease Physician
26-276
MS
2085R0202X
Diagnostic Radiology Physician
26-276
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013195
—
MS
Enumeration date
09/21/2012
Last updated
01/30/2014
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