OrganizationActive
Magnolia Specialty Clinic
NPI 1104464395 · Endocrinology, Diabetes & Metabolism Physician · Corinth, MS
Provider details
- NPI number
- 1104464395
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Marc Nakagawa, Cfo(662) 293-7660
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3704 Highway 72 W
Corinth, MS 38834-8556
Phone: (662) 665-8041
Fax: (662) 665-8049
Approximate (ZIP-level) locationGet directions
Mailing address
401 Alcorn Dr Ste 2c
Corinth, MS 38834-9073
Registry dates
- Enumerated
- 2019-12-18
- Last updated
- 2021-05-14
- Certified
- 2021-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.