Organization
NORTH MISSISSIPPI FACULTY PRACTICE
Active
Parent organization
NORTH MISSISSIPPI FACULTY PRACTICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH MISSISSIPPI FACULTY PRACTICE
Authorized official
GERALD KIMBROUGH (DIRECTOR)
(662) 377-4685
Entity
Organization
Contact information
Practice address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2263
Mailing address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
10/30/2012
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