Provider Demographics
NPI:1104101575
Name:NORTH MISSISSIPPI MEDICAL CENTER SERVICES, LLC
Entity type:Organization
Organization Name:NORTH MISSISSIPPI MEDICAL CENTER SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-377-4229
Mailing Address - Street 1:607 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6337
Mailing Address - Country:US
Mailing Address - Phone:662-377-8921
Mailing Address - Fax:662-377-8926
Practice Address - Street 1:607 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6337
Practice Address - Country:US
Practice Address - Phone:662-377-8921
Practice Address - Fax:662-377-8926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI MEDICAL CENTER SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-18
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302G707180Medicare PIN