Organization
MAGNOLIA GENERAL AND VASCULAR SURGERY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD NELSON (VP PHYSAICIAN SERVICES)
(662) 293-7618
Entity
Organization
Contact information
Practice address
611 ALCORN DR STE 210, CORINTH, MS 38834-9323
(662) 284-9910
(662) 284-9970
Mailing address
P.O BOX 2040, CORINTH, MS 38835-2040
(662) 284-9910
(662) 284-9970
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
10/31/2014
Last updated
05/14/2021
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