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COPIAH COUNTY MEDICAL CENTER NPI 1356448591


NPI Information

NPI: 1356448591
Provider Name: COPIAH COUNTY MEDICAL CENTER

Doing Business As: HAZLEHURST CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D0317528

Address:
213 CALDWELL DR
HAZLEHURST, MS
ZIP 39083
Phone: (601) 894-2514
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COPIAH COUNTY MEDICAL CENTER is a family medicine in Hazlehurst, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. COPIAH COUNTY MEDICAL CENTER NPI is 1356448591. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Hazlehurst Clinic.

The provider's business location address is:

213 CALDWELL DR
HAZLEHURST, MS
ZIP 39083
Phone: (601) 894-2514
Fax: (601) 894-2514

The provider's authorized official is Kortney M. Gaddy .
The authorized official title is Cfo and has the following contact phone number (601) 574-7200.

The CLIA number assigned to this NPI record is 25D0317528 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 9/22/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineMISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100113908MEDICAIDMISSISSIPPI
200116996MEDICAIDMISSISSIPPI
300015329MEDICAIDMISSISSIPPI
409013707MEDICAIDMISSISSIPPI
500119484MEDICAIDMISSISSIPPI
600012939MEDICAIDMISSISSIPPI
700011981MEDICAIDMISSISSIPPI
800122024MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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