Brookhaven Internal Medicine, P.a. | |
527 Silver Cross Dr Brookhaven MS 39601-2388 | |
(601) 835-0507 | |
(601) 835-2766 |
Full Name | Brookhaven Internal Medicine, P.a. |
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Speciality | Internal Medicine |
Location | 527 Silver Cross Dr, Brookhaven, Mississippi |
Authorized Official Name and Position | Diane M Price (OFFICE MANAGER) |
Authorized Official Contact | 6018350507 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brookhaven Internal Medicine, P.a. Po Box 3730 Brookhaven MS 39603-7730 Ph: (601) 835-0507 | Brookhaven Internal Medicine, P.a. 527 Silver Cross Dr Brookhaven MS 39601-2388 Ph: (601) 835-0507 |
NPI Number | 1699884528 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 7810030319 |
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Medicare Enrollment ID | O20100205000461 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699884528 | NPI | - | NPPES |
09014373 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Bryan S. Calcote |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073622999 PECOS PAC ID: 6800939307 Enrollment ID: I20100826000804 |
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