NPI 1043780836

East Mississippi Community College

Organisation General Practice Physician Scooba, MS

Practice location

Address: 1512 Kemper St, Scooba, MS 39358-7601
Phone: (972) 367-4845
Mailing address: 5050 Spring Valley Rd, Dallas, TX 75244-3995

Authorised official

Name: Mouzon Bass
Title: Administrator/Agent
Phone: (972) 367-4845

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Mississippi →

Registry record

NPI: 1043780836
Entity type: Organization
NPI issued: 5 Dec 2018
Record last updated: 5 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.