Provider Demographics
| NPI: | 1053469486 |
|---|---|
| Name: | NORTH MISSISSIPPI MEDICAL CLINICS INC |
| Entity type: | Organization |
| Organization Name: | NORTH MISSISSIPPI MEDICAL CLINICS INC |
| Other - Org Name: | |
| 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: | 808 VARSITY DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TUPELO |
| Mailing Address - State: | MS |
| Mailing Address - Zip Code: | 38801-4613 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 662-377-2774 |
| Mailing Address - Fax: | 662-377-2057 |
| Practice Address - Street 1: | 808 VARSITY DR |
| Practice Address - Street 2: | |
| Practice Address - City: | TUPELO |
| Practice Address - State: | MS |
| Practice Address - Zip Code: | 38801-4613 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 662-377-4685 |
| Practice Address - Fax: | 662-377-2057 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-01-08 |
| Last Update Date: | 2025-01-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207QG0300X | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| AL | I345 | Other | MEDICARE GROUP |
| MS | CA7889 | Other | RAILROAD MEDICARE GROUP |
| AL | F097 | Other | MEDICARE GROUP |
| MS | C02394 | Medicare PIN |