| Brooksville Medical Clinic Inc | |
|
139 N. Oliver St. Brooksville MS 39739-0348 | |
| (662) 738-4424 | |
| (662) 738-4615 |
| Full Name | Brooksville Medical Clinic Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 139 N. Oliver St., Brooksville, Mississippi |
| Authorized Official Name and Position | Ernest Roy Stuart (PRESIDENT) |
| Authorized Official Contact | 6627384424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooksville Medical Clinic Inc Po Box 348 139 N. Oliver St. Brooksville MS 39739-0348 Ph: (662) 738-4424 | Brooksville Medical Clinic Inc 139 N. Oliver St. Brooksville MS 39739-0348 Ph: (662) 738-4424 |
| NPI Number | 1922171826 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922171826 | NPI | - | NPPES |
| 09014825 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 253912 (Mississippi) | Primary |
Brooksville Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 139 North Oliver Street, Brooksville, MS 39739 Phone: 662-738-4424 Fax: 662-438-4615 |