Batesville Medical Clinic, Llc | |
107 Eureka St Ste A Batesville MS 38606-2533 | |
(662) 563-6000 | |
(662) 563-2200 |
Full Name | Batesville Medical Clinic, Llc |
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Speciality | Family Medicine |
Location | 107 Eureka St Ste A, Batesville, Mississippi |
Authorized Official Name and Position | Michael R Havens (MEDICAL DIRECTOR/OWNER) |
Authorized Official Contact | 6625636000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Batesville Medical Clinic, Llc 107 Eureka St Ste A Batesville MS 38606-2533 Ph: (662) 563-6000 | Batesville Medical Clinic, Llc 107 Eureka St Ste A Batesville MS 38606-2533 Ph: (662) 563-6000 |
NPI Number | 1164077525 |
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Provider Enumeration Date | 08/02/2019 |
Last Update Date | 05/12/2022 |
Medicare PECOS PAC ID | 6305176132 |
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Medicare Enrollment ID | O20190921000059 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164077525 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Michael R Havens |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316928955 PECOS PAC ID: 6103925441 Enrollment ID: I20070627000174 |
Provider Name | Victoria H Wilbanks |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609369586 PECOS PAC ID: 0446507180 Enrollment ID: I20180726000057 |
Provider Name | Hannah Devazier |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720552755 PECOS PAC ID: 0446663454 Enrollment ID: I20210113000370 |
Provider Name | Katherine Corbin Shook |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225757123 PECOS PAC ID: 6800272659 Enrollment ID: I20220930001145 |
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