<unavail> in Pontotoc, MS - Medicare Family Medicine

is a medicare enrolled primary clinic (Family Medicine) in Pontotoc, Mississippi. The current practice location for is 47 S Main St, Pontotoc, Mississippi. For appointments, you can reach them via phone at (662) 499-2802. The mailing address for is Po Box 507, Pontotoc, Mississippi and phone number is (662) 308-7045.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1831710623. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 499-2802.

Contact Information


	47 S Main St Pontotoc MS 38863-2823
	(662) 499-2802
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Family Medicine
Location	47 S Main St, Pontotoc, Mississippi
Authorized Official Name and Position	Christopher Park (OWNER/PHYSICIAN)
Authorized Official Contact	6623974597
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 507 Pontotoc MS 38863-0507 Ph: (662) 308-7045	47 S Main St Pontotoc MS 38863-2823 Ph: (662) 499-2802

NPI Details:

NPI Number	1831710623
Provider Enumeration Date	05/03/2020
Last Update Date	02/18/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	6204258064
Medicare Enrollment ID	O20200624001003

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831710623	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Christopher L Park
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1710181078 PECOS PAC ID: 1557448610 Enrollment ID: I20080414000516

Provider Name	Leslie Kay Eaton
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1417504796 PECOS PAC ID: 7416386925 Enrollment ID: I20200404000343

Reviews and Comments

Family Medicine in Pontotoc, MS

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Flavia H West Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 183 S Main St, Pontotoc, MS 38863 Phone: 662-489-5038 Fax: 662-489-7004
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 345 Highway 15 N, Pontotoc, MS 38863 Phone: 662-489-7430
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 Highway 15 N, Pontotoc, MS 38863 Phone: 662-489-7430 Fax: 662-489-7938
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11 E Jefferson St, Pontotoc, MS 38863 Phone: 662-419-1260

- Medicare Primary Care in Pontotoc, MS