Organization
COPIAH COUNTY MEDICAL CENTER
Active
Parent organization
COPIAH COUNTY MEDICAL CENTER
Other names
Crystal Springs Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COPIAH COUNTY MEDICAL CENTER
Authorized official
KORTNEY M. GADDY (CFO)
(601) 574-7200
Entity
Organization
Contact information
Practice address
123 BO BO DR, CRYSTAL SPRINGS, MS 39059
(601) 892-2225
(601) 892-1456
Mailing address
27190 HWY 28, HAZLEHURST, MS 39083
(601) 574-7000
(601) 892-1456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MS
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011981
—
MS
05
—
00012939
—
MS
05
—
00015329
—
MS
05
—
00113908
—
MS
05
—
00116996
—
MS
05
—
00119484
—
MS
05
—
00122024
—
MS
05
—
09014049
—
MS
Enumeration date
09/22/2006
Last updated
06/23/2025
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