Kilmichael Hospital Professional Group

LBN: Kilmichael Hospital
Kilmichael Hospital Professional Group is an health care organization with primary practice located at 301 Lamar Ave. , Kilmichael MS 39747-0188. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty. Kilmichael Hospital can be contacted via phone (662) 262-4311, or through Johnson, Calvin Dexter via phone (662) 262-4311.

Contact Information

Primary practice address
301 Lamar Ave. Kilmichael MS 39747-0188
Phone: (662) 262-4311
Fax: (662) 262-5586
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Calvin Dexter
Phone: (662) 262-4311

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12496 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16482 Mississippi
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 000010138 Mississippi
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 10138 Mississippi
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MS06391 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R605859 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X R504696 Mississippi

Profile Details

NPI number 1518176445
LBN Legal business name Kilmichael Hospital
DBA Doing business as Kilmichael Hospital Professional Group
Authorized official Johnson, Calvin Dexter
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2007
Last updated May 17th, 2011 - about 14 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 1518176445 NPPES
Mississippi MEDICAID 03335377
Mississippi Other 19147

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