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Organization

NORTH MISSISSIPPI MEDICAL CENTER

Active
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Organization

NORTH MISSISSIPPI MEDICAL CENTER

Active
Other names
Sleep Lab
Organization subpart
No

Provider details

NPI number
Authorized official
GERALD WAGES (COO)
(662) 377-3000
Entity
Organization

Contact information

Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-4685
(662) 377-2755
Mailing address
PO BOX 4018, TUPELO, MS 38803-4018
(662) 377-4685
(662) 377-2755

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09420762
MS
01
C03168
MEDICARE GROUP NUMBER
MS
Enumeration date
09/28/2006
Last updated
08/03/2007
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