Organization
OBSTETRICS GYNECOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRI HODGES (ADMINISTRATOR)
(662) 842-7080
Entity
Organization
Contact information
Practice address
1793 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6723
(662) 842-1161
(662) 844-4107
Mailing address
1793 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6723
(662) 842-1161
(662) 844-4107
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014159
—
MS
01
—
CM7073
RAILROAD MEDICARE GROUP
MS
Enumeration date
01/27/2006
Last updated
01/30/2008
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