Brooks Medical Clinic | |
2113 South Tate Street Corinth MS 38834 | |
(662) 331-1497 | |
(662) 331-1495 |
Full Name | Brooks Medical Clinic |
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Speciality | Clinic/Center |
Location | 2113 South Tate Street, Corinth, Mississippi |
Authorized Official Name and Position | Scherun Michelle Brooks (OWNER/OPERATOR SOLE MBR) |
Authorized Official Contact | 6623311497 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brooks Medical Clinic 2113 South Tate Street Corinth MS 38834 Ph: (662) 331-1497 | Brooks Medical Clinic 2113 South Tate Street Corinth MS 38834 Ph: (662) 331-1497 |
NPI Number | 1194215681 |
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Provider Enumeration Date | 05/10/2018 |
Last Update Date | 11/09/2018 |
Medicare PECOS PAC ID | 0749534170 |
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Medicare Enrollment ID | O20181121000466 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194215681 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Scherun Brooks |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407120280 PECOS PAC ID: 7416105184 Enrollment ID: I20120924000173 |
Provider Name | Ashley M Talley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548683790 PECOS PAC ID: 9931323276 Enrollment ID: I20140606001422 |
Provider Name | April D Holley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386117042 PECOS PAC ID: 2668802372 Enrollment ID: I20200421001399 |
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