| Mississippi Band Of Choctaw Indians | |
|
376 Campus Rd Conehatta MS 39057-2800 | |
| (601) 656-2211 | |
| (601) 663-7721 |
| Full Name | Mississippi Band Of Choctaw Indians |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 376 Campus Rd, Conehatta, Mississippi |
| Authorized Official Name and Position | Phyllils J Anderson (TRIBAL CHIEF) |
| Authorized Official Contact | 6016562211 |
| 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 376 Campus Rd Conehatta MS 39057-2800 Ph: (601) 656-2211 |
| NPI Number | 1013092600 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 06/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013092600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |