| Cotton Plant Family Clinic | |
|
100 County Road 714 Blue Mountain MS 38610-9743 | |
| (662) 538-4111 | |
| (662) 538-4128 |
| Full Name | Cotton Plant Family Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 100 County Road 714, Blue Mountain, Mississippi |
| Authorized Official Name and Position | Phyllis G Koonce (OWNER SOLE PROVIDER) |
| Authorized Official Contact | 6625384111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cotton Plant Family Clinic 100 County Road 714 Blue Mountain MS 38610-9743 Ph: (662) 538-4111 | Cotton Plant Family Clinic 100 County Road 714 Blue Mountain MS 38610-9743 Ph: (662) 538-4111 |
| NPI Number | 1891911186 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 07/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891911186 | NPI | - | NPPES |
| 06577891 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | R125960 (Mississippi) | Primary |
Blue Mountain Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 North Guyton, Blue Mountain, MS 38610 Phone: 662-685-4700 Fax: 662-685-9999 | |
Cotton Plant Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 County Road 714, Blue Mountain, MS 38610 Phone: 662-538-4111 Fax: 662-538-4128 | |
Thompson Medical Service Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 Hwy 15 North, Blue Mountain, MS 38610 Phone: 662-316-0414 | |
Family Clinic Of Cotton Plant, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 County Road 714, Blue Mountain, MS 38610 Phone: 662-538-4111 Fax: 662-538-4128 |