Crystal Springs Clinic

LBN: Copiah County Medical Center
Crystal Springs Clinic is an health care organization with primary practice located at 123 Bo Bo Dr , Crystal Springs MS 39059. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Copiah County Medical Center can be contacted via phone (601) 892-1456, or through Gaddy, Kortney M. via phone (601) 574-7200.

Contact Information

Primary practice address
123 Bo Bo Dr Crystal Springs MS 39059
Phone: (601) 892-1456
Fax: (601) 892-1456
Website:
Map and Directions
Authorized official contact:
Name: Gaddy, Kortney M.
Phone: (601) 574-7200

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Mississippi

Profile Details

NPI number 1972603819
LBN Legal business name Copiah County Medical Center
DBA Doing business as Crystal Springs Clinic
Authorized official Gaddy, Kortney M.
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 22nd, 2006
Last updated Sep 22nd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972603819 NPPES
Mississippi MEDICAID 09014049
Mississippi MEDICAID 00116996
Mississippi MEDICAID 00012939
Mississippi MEDICAID 00015329
Mississippi MEDICAID 00011981
Mississippi MEDICAID 00113908
Mississippi MEDICAID 00119484
Mississippi MEDICAID 00122024

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