| 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 |