| Organization Name: | BAPTIST MEDICAL CENTER-LEAKE, INC |
| NPI Number: | 1356626618 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY GRISSETT (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 1225 N State St Jackson |
| State: | MS US |
| Postal Code: | 392022064 |
| Phone Number: | 6019681000 |
| Fax Number: | |
| NPI Enumeration Date: | 10/19/2011 |
| NPI Last Update Date: | 07/23/2012 |
| 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: | |