| Coffeeville Medical Clinic | |
|
14430 Main St Coffeeville MS 38922-2590 | |
| (662) 675-2500 | |
| (662) 675-2501 |
| Full Name | Coffeeville Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 14430 Main St, Coffeeville, Mississippi |
| Authorized Official Name and Position | Terry L Varner (ADMINISTRATOR) |
| Authorized Official Contact | 6624731411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffeeville Medical Clinic 14430 Main St Coffeeville MS 38922-2590 Ph: (662) 675-2500 | Coffeeville Medical Clinic 14430 Main St Coffeeville MS 38922-2590 Ph: (662) 675-2500 |
| NPI Number | 1639236383 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 02/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639236383 | NPI | - | NPPES |
| 9014717 | Medicaid | MS | |
| 00120194 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Arrington Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14415 Main St, Coffeeville, MS 38922 Phone: 662-473-5143 Fax: 662-473-4991 |