Provider Demographics
NPI:1871888271
Name:MAGEE BENEVOLENT ASSOCIATION
Entity type:Organization
Organization Name:MAGEE BENEVOLENT ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRUMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-849-7245
Mailing Address - Street 1:105 EATON STREET
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39168
Mailing Address - Country:US
Mailing Address - Phone:601-785-6786
Mailing Address - Fax:601-785-7929
Practice Address - Street 1:105 EATON STREET
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:MS
Practice Address - Zip Code:39168
Practice Address - Country:US
Practice Address - Phone:601-785-6786
Practice Address - Fax:601-785-7929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty