Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

State of Mississippi-University of Mississippi Medical Center

Organization Family Medicine Physician · NPI 1932538527

State of Mississippi-University of Mississippi Medical Center is a Family Medicine Physician in Grenada, Mississippi. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

965 Avent Dr Ste 100A
Grenada, MS 38901-5045
Phone: (662) 227-7444
Fax: (662) 227-7443
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1932538527
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Mississippi - University of Mississippi Medical Center
Authorized official Kevin Cook — Ceo · (601) 984-4113
Other names University Of Mississippi Medical Center-Grenada Specialty Clinic
NPI enumeratedNovember 5, 2013
Last updated in NPPESMarch 6, 2014
Mailing address2500 N State St, Jackson, MS 39216-4500

Other providers in Grenada