Magnolia Surgical Clinic

NPI #1629516968 in Corinth, Mississippi

Provider Information

NPI Number: 1629516968
Entity Type: Organization
Organization Name: Magnolia Surgical Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: MAGNOLIA REGIONAL HEALTH CENTER
Primary Specialty: Surgery
Enumeration Date: Feb 7, 2017
Last Updated: Feb 7, 2017

Practice Location

Address: 703 ALCORN DR
Address 2: SUITE 102
City: Corinth
State: Mississippi
ZIP Code: 38834-9302
Phone: (662) 286-2522

Authorized Official

Name: RONNY D HUMES
Title: CEO
Phone: (662) 293-7664

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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Individual Providers

Provider Name	Specialty	City
Mathew Bowen Johnson JR., M.D.	Surgery	Corinth	AI Deep Dive
DR. Benjamin Daniel Pettigrew, DO	Surgery	Corinth	AI Deep Dive
DR. James D. Edmonson, M.D.	Surgery	Corinth	AI Deep Dive
Andy Wade Holley, D.O.	Surgery	Corinth	AI Deep Dive

Organizations

Provider Name	Specialty	City
North Mississippi Medical Center, Inc.	Surgery	Corinth	AI Deep Dive

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