| Children's Clinic | |
|
199 Grandstand Place Tupelo MS 38804 | |
| (662) 377-7337 | |
| (662) 842-1350 |
| Full Name | Children's Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 199 Grandstand Place, Tupelo, Mississippi |
| Authorized Official Name and Position | Bruce Toppin (SECRETARY) |
| Authorized Official Contact | 6623773000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Clinic 199 Grandstand Place Suite 101 Tupelo MS 38804 Ph: (662) 377-7337 | Children's Clinic 199 Grandstand Place Tupelo MS 38804 Ph: (662) 377-7337 |
| NPI Number | 1649727447 |
|---|---|
| Provider Enumeration Date | 09/09/2016 |
| Last Update Date | 09/09/2021 |
| Medicare PECOS PAC ID | 9931010600 |
|---|---|
| Medicare Enrollment ID | O20171220002714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649727447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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