Physician Group
NPI #1558679902 in Meridian, Mississippi
Provider Information
- NPI Number
- 1558679902
- Entity Type
- Organization
- Organization Name
- Physician Group
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- EAST MISSISSIPPI STATE HOSPITAL
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Sep 20, 2010
- Last Updated
- May 12, 2020
Practice Location
- Address
- 4555 HIGHLAND PARK DR
- City
- Meridian
- State
- Mississippi
- ZIP Code
- 39307-5429
- Phone
- (601) 581-7969
Authorized Official
- Name
- DR. CHARLES CARLISLE
- Title
- HOSPITAL DIRECTOR
- Phone
- (601) 581-7877
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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