| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 803 1st St, Cleveland, Mississippi |
| Authorized Official Name and Position | Jerry Adams (CEO) |
| Authorized Official Contact | 6624597000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
803 1st St Cleveland MS 38732-2309 Ph: (662) 843-2721 | 803 1st St Cleveland MS 38732-2309 Ph: (662) 843-2721 |
| NPI Number | 1740259282 |
|---|---|
| Provider Enumeration Date | 03/16/2006 |
| Last Update Date | 02/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740259282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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