Organization
SOUTH PIKE
Active
Other names
Osyka Elementary Children's Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BILL GUNNELL (DISTRICT SUPERINTENDENT)
(601) 783-3742
Entity
Organization
Contact information
Practice address
444 AMITE STREET, OSYKA, MS 39657
(601) 542-3354
Mailing address
444 AMITE STREET, OSYKA, MS 39657
(601) 542-3354
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R868937
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06787291
—
MS
Enumeration date
05/03/2007
Last updated
08/22/2020
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