Magnolia Gastroenterology Clinic, Llc | |
3050 Corder Drive Magnolia Gastroenterology Clinic, Llc Corinth MS 38834 | |
(662) 284-9902 | |
(662) 284-9904 |
Full Name | Magnolia Gastroenterology Clinic, Llc |
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Speciality | Internal Medicine |
Location | 3050 Corder Drive, Corinth, Mississippi |
Authorized Official Name and Position | Fredrick Alvin Corder (OWNER/PHYSICIAN/MEDICAL DIRECTOR) |
Authorized Official Contact | 6622849902 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Magnolia Gastroenterology Clinic, Llc Po Box 600 Corinth MS 38835-0600 Ph: (662) 284-9902 | Magnolia Gastroenterology Clinic, Llc 3050 Corder Drive Magnolia Gastroenterology Clinic, Llc Corinth MS 38834 Ph: (662) 284-9902 |
NPI Number | 1518941731 |
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Provider Enumeration Date | 12/01/2005 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 6800844507 |
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Medicare Enrollment ID | O20050110000663 |
Identifier | Type | State | Issuer |
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1518941731 | NPI | - | NPPES |
09016046 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Allene R Jolly |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1538106802 PECOS PAC ID: 8426036393 Enrollment ID: I20040708000976 |
Provider Name | Cheryl Burcham |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1538270996 PECOS PAC ID: 6103854492 Enrollment ID: I20050728000500 |
Provider Name | Tara W Wadkins |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1265563365 PECOS PAC ID: 7719085687 Enrollment ID: I20070531000519 |
Provider Name | Frederick A Corder |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1710961982 PECOS PAC ID: 8527016229 Enrollment ID: I20100915000696 |
Provider Name | Alicia M Nabors |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1609125269 PECOS PAC ID: 8426206111 Enrollment ID: I20130320000288 |
Provider Name | Amy Massengill Sanders |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1689923401 PECOS PAC ID: 0143479998 Enrollment ID: I20161013000941 |
Provider Name | Christopher Harrison Wright |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1023507852 PECOS PAC ID: 1850636697 Enrollment ID: I20190326001057 |
Provider Name | Jessica Star Harkey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295377968 PECOS PAC ID: 5698108900 Enrollment ID: I20191127000460 |
Provider Name | Carrie Wilbanks Harvey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467078790 PECOS PAC ID: 2567885817 Enrollment ID: I20200706002113 |
Provider Name | Lydia Makapugay |
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Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1982605820 PECOS PAC ID: 1759366529 Enrollment ID: I20240325003900 |
Mrh Medical Group, Corinth Alcorn Dr. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 508 Alcorn Dr, Corinth, MS 38834 Phone: 663-396-4733 | |
Magnolia Physician Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 Alcorn Dr, Corinth, MS 38834 Phone: 662-293-7618 | |
Magnolia Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 703 Alcorn Dr, Suite 109, Corinth, MS 38834 Phone: 662-286-1499 Fax: 662-286-9041 | |
Magnolia Regional Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3714 Highway 72 W, Corinth, MS 38834 Phone: 662-293-1575 Fax: 662-293-1576 | |
Magnolia Infectious Disease Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 Alcorn Dr, Corinth, MS 38834 Phone: 662-293-1000 | |
Magnolia Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Norman Rd, Corinth, MS 38834 Phone: 662-293-1000 | |
Magnolia Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3704 Highway 72 W, Corinth, MS 38834 Phone: 662-665-8041 Fax: 662-665-8049 |