| |
106 Clinton Parkway Clinton MS 39056 | |
(601) 924-9005 | |
(601) 925-9463 |
Full Name | |
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Speciality | Family Medicine |
Location | 106 Clinton Parkway, Clinton, Mississippi |
Authorized Official Name and Position | Elizabeth H Mullins (DIRECTOR OF CLINIC ADMINISTRATION) |
Authorized Official Contact | 6012924261 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1151 N State St Ste 408 Jackson MS 39202-2464 Ph: (601) 292-4261 | 106 Clinton Parkway Clinton MS 39056 Ph: (601) 924-9005 |
NPI Number | 1124241245 |
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Provider Enumeration Date | 04/10/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124241245 | NPI | - | NPPES |
09014808 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Clinton Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Highway 80 E, Suite D, Clinton, MS 39056 Phone: 318-791-3765 Fax: 877-747-5326 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 498 Highway 80 E, Clinton, MS 39056 Phone: 601-924-4000 | |