Magnolia Orthopaedics & Sports Medicine, P.A.

LBN: Magnolia Orthopaedics & Sports Medicine, P.A.
Magnolia Orthopaedics & Sports Medicine, P.A. is an health care organization with primary practice located at 611 Alcorn Dr Suite 100, Corinth MS 38834-9321. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Magnolia Orthopaedics & Sports Medicine, P.A. can be contacted via phone (662) 286-6369, or through Gooch, Charlie via phone (662) 286-6369.

Contact Information

Primary practice address
611 Alcorn Dr Suite 100 Corinth MS 38834-9321
Phone: (662) 286-6369
Fax: (662) 286-2768
Website:
Map and Directions
Authorized official contact:
Name: Gooch, Charlie
Phone: (662) 286-6369

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X

Profile Details

NPI number 1063433233
LBN Legal business name Magnolia Orthopaedics & Sports Medicine, P.A.
DBA Doing business as
Authorized official Gooch, Charlie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2006
Last updated Aug 15th, 2013 - about 12 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 1063433233 NPPES
Mississippi MEDICAID 09013928

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