| Mississippi Band Of Choctaw Indians | |
| 
					210 Hospital Cir Choctaw MS 39350-6781  | |
| (601) 656-2211 | |
| (601) 663-7721 | 
| Full Name | Mississippi Band Of Choctaw Indians | 
|---|---|
| Speciality | Clinic/center - Public Health, Federal | 
| Location | 210 Hospital Cir, Choctaw, Mississippi | 
| Authorized Official Name and Position | Phyllis J Anderson (TRIBAL CHIEF) | 
| Authorized Official Contact | 6016562582 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mississippi Band Of Choctaw Indians 210 Hospital Cir Choctaw MS 39350-6781 Ph: (601) 656-2211  | Mississippi Band Of Choctaw Indians 210 Hospital Cir Choctaw MS 39350-6781 Ph: (601) 656-2211  | 
| NPI Number | 1255533758 | 
|---|---|
| Provider Enumeration Date | 06/05/2007 | 
| Last Update Date | 07/02/2012 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1255533758 | NPI | - | NPPES | 
| 9015768 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |