| Cleveland Medical Clinic Pllc | |
|
810 E Sunflower Rd Suite 100a Cleveland MS 38732-2800 | |
| (662) 843-3606 | |
| (662) 846-1194 |
| Full Name | Cleveland Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 810 E Sunflower Rd, Cleveland, Mississippi |
| Authorized Official Name and Position | Tommicile Dean Rogers (ADMINISTRATOR) |
| Authorized Official Contact | 6628433606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleveland Medical Clinic Pllc Po Box 1629 Cleveland MS 38732-1629 Ph: (662) 843-3606 | Cleveland Medical Clinic Pllc 810 E Sunflower Rd Suite 100a Cleveland MS 38732-2800 Ph: (662) 843-3606 |
| NPI Number | 1134347958 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 02/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134347958 | NPI | - | NPPES |
| 08803095 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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