| Organization Name: | BAPTIST MEDICAL CENTER - LEAKE, INC. |
| NPI Number: | 1194861260 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID JACKSON (ADMINISTRATOR) |
| Mailing Address: | 1100 Hwy 16 East Carthage |
| State: | MS US |
| Postal Code: | 390513809 |
| Phone Number: | 6012671470 |
| Fax Number: | 6012671469 |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 01/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |