Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

East Mississippi Community College

Organization General Practice Physician · NPI 1043780836

East Mississippi Community College provides General Practice Physician services in Scooba, Mississippi. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

1512 Kemper St
Scooba, MS 39358-7601
Phone: (972) 367-4845
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1043780836
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names Emcc Sports Medicine
NPI enumeratedDecember 5, 2018
Last updated in NPPESDecember 5, 2018
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995