Organization
NORTH MISSISSIPPI MEDICAL CLINICS
Active
Other names
North MS Neurosurgical Services
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD KIMBROUGH (MANAGER)
(662) 377-4685
Entity
Organization
Contact information
Practice address
4381 S EASON BLVD STE 302, TUPELO, MS 38801-6584
(662) 377-5700
(662) 377-5720
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016182
—
MS
Enumeration date
09/11/2006
Last updated
08/22/2020
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