Pediatric & Adolescent Clinic | |
308 Highland Blvd Natchez MS 39120-4611 | |
(601) 442-7676 | |
(601) 442-9590 |
Full Name | Pediatric & Adolescent Clinic |
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Speciality | Clinic/center - Rural Health |
Location | 308 Highland Blvd, Natchez, Mississippi |
Authorized Official Name and Position | David Alan Timm (OWNER) |
Authorized Official Contact | 6014427676 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pediatric & Adolescent Clinic 308 Highland Blvd Natchez MS 39120-4611 Ph: (601) 442-7676 | Pediatric & Adolescent Clinic 308 Highland Blvd Natchez MS 39120-4611 Ph: (601) 442-7676 |
NPI Number | 1174608020 |
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Provider Enumeration Date | 10/26/2006 |
Last Update Date | 01/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174608020 | NPI | - | NPPES |
1446009 | Medicaid | LA | |
09015251 | Medicaid | MS |
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