1962748087 NPI number — SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT

Table of content: (NPI 1962748087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962748087 NPI number — SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962748087
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 S WALL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATCHEZ
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39120-3477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 S WALL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATCHEZ
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39120-3477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-446-6044
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
PETERSON
Authorized Official First Name:
WIRT
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
601-446-6044

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00770117 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06026374 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1467556092 . This is a "NPI" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1861591075 . This is a "NPI" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 00636206 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1811169840 . This is a "NPI" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 00770314 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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