| |
208 Country Club Rd Houston MS 38851-9326 | |
(662) 456-3437 | |
(662) 456-2070 |
Full Name | |
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Speciality | Family Medicine |
Location | 208 Country Club Rd, Houston, Mississippi |
Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623774229 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-3204 | 208 Country Club Rd Houston MS 38851-9326 Ph: (662) 456-3437 |
NPI Number | 1710097134 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 01/21/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710097134 | NPI | - | NPPES |
009013750 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Digestive Disease Center Of Houston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 E Madison St, Houston, MS 38851 Phone: 662-456-9203 Fax: 662-456-9206 |