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505 Airport Rd Ste D Forest MS 39074-4033 | |
(601) 333-0986 | |
(601) 333-0987 |
Full Name | |
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Speciality | Clinic/center |
Location | 505 Airport Rd Ste D, Forest, Mississippi |
Authorized Official Name and Position | John P Lee (CHAIRMAN OF THE BOARD) |
Authorized Official Contact | 6014694151 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box D Forest MS 39074-0558 Ph: (601) 469-4151 | 505 Airport Rd Ste D Forest MS 39074-4033 Ph: (601) 333-0986 |
NPI Number | 1225720345 |
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Provider Enumeration Date | 05/25/2023 |
Last Update Date | 06/06/2023 |
Identifier | Type | State | Issuer |
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1225720345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Forest Family Practice Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Ln, Forest, MS 39074 Phone: 601-469-4861 Fax: 601-469-4828 | |
Independent Healthcare Management, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 516 Airport Rd, Forest, MS 39074 Phone: 601-469-4151 Fax: 601-469-3681 | |