LEAKE MEMORIAL MEDICAL CLINIC WALNUT GROVE
NPI 1053576819
General Acute Care Hospital - Rural in Walnut Grove, MS

Active since July 22, 2008
110 PARK ST, WALNUT GROVE, MS 39189(601) 267-1400(601) 253-9464 Get Directions Write a Review

NPPES record last updated: July 22, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Leake Memorial Medical Clinic Walnut Grove NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEAKE MEMORIAL MEDICAL CLINIC WALNUT GROVE (NPI 1053576819) is a healthcare organization registered as a rural in Walnut Grove, Mississippi and active in the NPI registry since July 2008. The organization lists Kristi Estep, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053576819
Entity TypeOrganization
Primary Taxonomy282NR1301X
Legal Business NameLEAKE MEMORIAL MEDICAL CLINIC WALNUT GROVE
Location Address110 PARK STWalnut Grove, MS 39189-6526
Mailing AddressPo Box 367Walnut Grove, MS 39189-0367 · (601) 267-1400 · Fax (601) 253-9464
Fax(601) 253-9464
Organization SubpartNo
Authorized OfficialKristi EstepOffice Manager · (601) 267-1400
Enumeration DateJuly 22, 2008
NPI 1053576819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral Acute Care Hospital · RuralHospitals
Taxonomy Code282NR1301X
110 PARK ST, Walnut Grove, MS 39189

Other Identifiers 1

Medicaid05874018MS

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
110 PARK ST
WALNUT GROVE, MS 39189
Clinic/Center (Rural Health)
110 PARK ST
WALNUT GROVE, MS 39189

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leake Memorial Medical Clinic Walnut Grove's NPI number?

The NPI number for Leake Memorial Medical Clinic Walnut Grove is 1053576819. It was assigned to this organization in the NPPES registry on July 22, 2008.

Where is Leake Memorial Medical Clinic Walnut Grove located?

Leake Memorial Medical Clinic Walnut Grove is located at 110 Park St, Walnut Grove, MS 39189. The listed phone number is (601) 267-1400.

What is Leake Memorial Medical Clinic Walnut Grove's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Rural, with taxonomy code 282NR1301X.

When was this NPI record last updated?

The NPPES record for Leake Memorial Medical Clinic Walnut Grove was last updated on July 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.