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4508 Highway 45 N Columbus MS 39705-2917 | |
(662) 328-9702 | |
(662) 328-0954 |
Full Name | |
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Speciality | Family Medicine |
Location | 4508 Highway 45 N, Columbus, Mississippi |
Authorized Official Name and Position | Joseph Gillis (OWNER) |
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 | 4508 Highway 45 N Columbus MS 39705-2917 Ph: (662) 328-9702 |
NPI Number | 1871006155 |
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Provider Enumeration Date | 11/09/2017 |
Last Update Date | 11/09/2017 |
Identifier | Type | State | Issuer |
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1871006155 | NPI | - | NPPES |
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