| Organization Name: | BAPTIST MEDICAL CENTER-LEAKE, INC |
| NPI Number: | 1548310782 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTI ESTEP (CLINIC SUPERVISOR) |
| Mailing Address: | 110 Park Street Walnut Grove |
| State: | MS US |
| Postal Code: | 39189 |
| Phone Number: | 6012671400 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 03/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |