Choctaw Medical Clinic | |
8613 Ms Highway 12 Ackerman MS 39735-8917 | |
(662) 285-4400 | |
Not Available |
Full Name | Choctaw Medical Clinic |
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Speciality | Clinic/Center |
Location | 8613 Ms Highway 12, Ackerman, Mississippi |
Authorized Official Name and Position | Susan Hollingsworth Wells (ADMINISTRATOR) |
Authorized Official Contact | 6622859460 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Choctaw Medical Clinic 8613 Ms Hwy 12 Campus Clinic Suite B Ackerman MS 39735-0719 Ph: (662) 285-9460 | Choctaw Medical Clinic 8613 Ms Highway 12 Ackerman MS 39735-8917 Ph: (662) 285-4400 |
NPI Number | 1003223306 |
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Provider Enumeration Date | 07/18/2014 |
Last Update Date | 05/03/2022 |
Medicare PECOS PAC ID | 2567682206 |
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Medicare Enrollment ID | O20141212000454 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003223306 | NPI | - | NPPES |
04477821 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Mississippi) | Primary |
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