National Provider Identifier Database

MAGNOLIA GASTROENTEROLOGY CLINIC LLC
Gastroenterology

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.


Contact Information

MAGNOLIA GASTROENTEROLOGY CLINIC, LLC
3050 CORDER DRIVE
MAGNOLIA GASTROENTEROLOGY CLINIC, LLC
CORINTH, MS38834
Phone: 662-284-9902
Fax: 662-284-9904
Website:
Specialty Taxonomy Code
* Gastroenterology 207RG0100X

* Indicates primary specialty

NPI Profile & details for MAGNOLIA GASTROENTEROLOGY CLINIC, LLC

NPI Number 1518941731
Legal business name
LBN
MAGNOLIA GASTROENTEROLOGY CLINIC, LLC
Authorized official FREDRICK CORDER - (OWNER/PHYSICIAN/MEDICAL DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/01/2005
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MS Medicaid: 09016046

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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