TUPELO MEDICAL GROUP, LLC (NPI# 1396783916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396783916 |
| Entity Type | Organization |
| Organization Name | TUPELO MEDICAL GROUP, LLC |
| Practice Address |
1265 Cliff Gookin Boulevard Tupelo MS 38801-6749 |
| Practice Telephone | 6628402131 |
| Practice Fax Number | 6628402522 |
| Mailing Telephone | 6624072528 |
| Mailing Fax Number | 6626209915 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2011-12-12 |
| Authorized Official Name | DR. JULIAN D. LODEN (VICE PRESIDENT) |
| Authorized Official Telephone | 6624072528 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09015601 | 05 |
| Street Address |
1265 CLIFF GOOKIN BOULEVARD |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174562318 | John Paul White | Internal Medicine | 1265 Cliff Gookin Boulevard, Tupelo, MS 38801 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841691615 | Emyrose Healthcare | Internal Medicine | 1705 Lakefield Dr, Tupelo, MS 38801-8420 | 2014-09-10 |
| 1912285446 | Edmond Collin Nelson Jr. | Internal Medicine | 1150 S Green St Ste 1a, North Mississippi Medical Cencer, Tupelo, MS 38804-4902 | 2011-08-02 |
| 1841344892 | Norris Vincent Crump Sr. | Internal Medicine | 898 Lynden Blvd, 898 Lynden Blvd, Tupelo, MS 38801 | 2007-01-23 |
| 1932155538 | Julian Dale Loden | Internal Medicine | 1265 Cliff Gookin Blvd, Tupelo, MS 38801-6749 | 2006-05-25 |
| 1164480109 | William Ensor Brohawn IIi | Internal Medicine | 3018 Plantation Cir W, Tupelo, MS 38804-9717 | 2006-05-01 |
| 1891767687 | Timothy Allen Albers | Internal Medicine | 410 Council Cir, Tupelo, MS 38801-4938 | 2006-02-06 |
| 1619406758 | Daymon D Peterson | Internal Medicine | 201 W Main St, Tupelo, MS 38804-3917 | 2017-06-11 |
| 1578910378 | Francis Ogbobe | Internal Medicine | 830 S Gloster St, Tupelo, MS 38801 | 2016-05-21 |
| 1033589163 | Pontotoc Health Providers | Internal Medicine | 450 E President Ave, Tupelo, MS 38801-5599 | 2015-10-01 |
| 1013385715 | North Mississippi Medical Center, Inc. | Internal Medicine | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2015-09-11 |
| Find all providers in TUPELO | ||||
Please comment or provide details below to improve the information on TUPELO MEDICAL GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.