Mississippi Band of Choctaw Indians

NPI #1275611543 in Carthage, Mississippi

Provider Information

NPI Number: 1275611543
Entity Type: Organization
Organization Name: Mississippi Band of Choctaw Indians
Subpart: Yes (part of a larger organization)
Parent Organization: MISSISSIPPI BAND OF CHOCTAW INDIANS
Primary Specialty: Clinic/Center - Public Health, Federal
Enumeration Date: Nov 2, 2006
Last Updated: Jun 15, 2012

Practice Location

Address: 1930 N PEARL ST
City: Carthage
State: Mississippi
ZIP Code: 39051-8220
Phone: (601) 656-2211

Authorized Official

Name: MRS. PHYLLIS J ANDERSON
Title: TRIBAL CHIEF
Phone: (601) 656-2211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Public Health, Federal — Public Health, Federal	261QP0904X	Primary

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