| |
56 Dutch Ln Columbus MS 39702-5500 | |
(662) 329-3808 | |
(662) 329-3873 |
Full Name | |
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Speciality | Family Medicine |
Location | 56 Dutch Ln, Columbus, Mississippi |
Authorized Official Name and Position | Tommy Gilreath (CFO) |
Authorized Official Contact | 6623275202 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | 56 Dutch Ln Columbus MS 39702-5500 Ph: (662) 329-3808 |
NPI Number | 1639681976 |
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Provider Enumeration Date | 10/26/2017 |
Last Update Date | 10/26/2017 |
Identifier | Type | State | Issuer |
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1639681976 | NPI | - | NPPES |
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