| Booneville Medical Clinic | |
|
1301 N 2nd St Booneville MS 38829-1028 | |
| (662) 728-2071 | |
| (662) 728-2077 |
| Full Name | Booneville Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1301 N 2nd St, Booneville, Mississippi |
| Authorized Official Name and Position | Gerald Kimbrough (MANAGER) |
| Authorized Official Contact | 6623774685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Booneville Medical Clinic 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | Booneville Medical Clinic 1301 N 2nd St Booneville MS 38829-1028 Ph: (662) 728-2071 |
| NPI Number | 1548370083 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548370083 | NPI | - | NPPES |
| 09014612 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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