| |
505 Willowbrook Rd Columbus MS 39705-2016 | |
(662) 329-9191 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 505 Willowbrook Rd, Columbus, Mississippi |
Authorized Official Name and Position | Kirnjot Singh (PRESIDENT) |
Authorized Official Contact | 2192284355 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10996 Four Seasons Pl Ste 100c Crown Point IN 46307-7762 Ph: (219) 228-1021 | 505 Willowbrook Rd Columbus MS 39705-2016 Ph: (662) 329-9191 |
NPI Number | 1659844405 |
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Provider Enumeration Date | 01/04/2019 |
Last Update Date | 06/17/2024 |
Medicare PECOS PAC ID | 0244505840 |
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Medicare Enrollment ID | O20190221000294 |
Identifier | Type | State | Issuer |
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1659844405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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