| Mid-town Medical | |
|
815 Childs Street Corinth MS 38834-3720 | |
| (662) 665-0006 | |
| (662) 665-9151 |
| Full Name | Mid-town Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 815 Childs Street, Corinth, Mississippi |
| Authorized Official Name and Position | Deborah B King (PRESIDENT) |
| Authorized Official Contact | 6626650006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-town Medical 815 Childs St Po Box 1854 Corinth MS 38834-4934 Ph: (662) 665-0006 | Mid-town Medical 815 Childs Street Corinth MS 38834-3720 Ph: (662) 665-0006 |
| NPI Number | 1134383482 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 3375617053 |
|---|---|
| Medicare Enrollment ID | O20080729000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134383482 | NPI | - | NPPES |
| 428040637B | Other | BCBS | |
| 00119995 | Medicaid | MS | |
| 500000543 | Other | MEDICARE | |
| S44159 | Other | MS | UPIN |
| Provider Name | Deborah B Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285700443 PECOS PAC ID: 1153495833 Enrollment ID: I20080729000389 |
| Provider Name | Anna K Erwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710249271 PECOS PAC ID: 4880843648 Enrollment ID: I20121011000394 |
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