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121 South Second Street Baldwyn MS 38824 | |
(662) 365-2725 | |
(662) 365-2737 |
Full Name | |
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Speciality | Clinic/Center |
Location | 121 South Second Street, Baldwyn, Mississippi |
Authorized Official Name and Position | Vicki Michelle Lambert (OWNER) |
Authorized Official Contact | 6623652725 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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121 South Second Street Baldwyn MS 38824 Ph: (662) 365-2725 | 121 South Second Street Baldwyn MS 38824 Ph: (662) 365-2725 |
NPI Number | 1215247937 |
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Provider Enumeration Date | 10/15/2010 |
Last Update Date | 06/20/2018 |
Medicare PECOS PAC ID | 5698964104 |
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Medicare Enrollment ID | O20110524000327 |
Identifier | Type | State | Issuer |
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1215247937 | NPI | - | NPPES |
01352318 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | R863085 (Mississippi) | Primary |
261QR1300X | Clinic/center - Rural Health | R574996 (Mississippi) | Secondary |
Provider Name | Vicki M Lambert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861663460 PECOS PAC ID: 2860553807 Enrollment ID: I20081209000277 |
Provider Name | Miranda Lou Ford |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275248460 PECOS PAC ID: 4880059716 Enrollment ID: I20230804000083 |
Waters Family Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Mill St, Baldwyn, MS 38824 Phone: 662-365-3253 Fax: 662-365-3484 | |