| Creekmore Clinic, P.l.l.c. | |
|
216 Oxford Road New Albany MS 38652-3115 | |
| (662) 534-9042 | |
| (662) 534-9707 |
| Full Name | Creekmore Clinic, P.l.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 216 Oxford Road, New Albany, Mississippi |
| Authorized Official Name and Position | Sam J Creekmore (PARTNER) |
| Authorized Official Contact | 6625349042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekmore Clinic, P.l.l.c. 216 Oxford Rd New Albany MS 38652-3115 Ph: (662) 534-9042 | Creekmore Clinic, P.l.l.c. 216 Oxford Road New Albany MS 38652-3115 Ph: (662) 534-9042 |
| NPI Number | 1073631164 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1052506961 |
|---|---|
| Medicare Enrollment ID | O20101117000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073631164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald Bradley Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790751469 PECOS PAC ID: 8123185709 Enrollment ID: I20090326000045 |
| Provider Name | Samuel J Creekmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578538591 PECOS PAC ID: 8325187958 Enrollment ID: I20101117000269 |
| Provider Name | Lashundra B Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962795815 PECOS PAC ID: 6901077106 Enrollment ID: I20110920000412 |
| Provider Name | Correal J Garrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427421528 PECOS PAC ID: 0547567406 Enrollment ID: I20160322000025 |
| Provider Name | Lyndie C Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639605967 PECOS PAC ID: 0648547521 Enrollment ID: I20170524001867 |
| Provider Name | Heaven A Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689185464 PECOS PAC ID: 4486912201 Enrollment ID: I20171227000645 |
| Provider Name | Hailey Ott Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104327667 PECOS PAC ID: 1759636434 Enrollment ID: I20180620002890 |
| Provider Name | James Craig Bullock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346747953 PECOS PAC ID: 3678821592 Enrollment ID: I20210909002016 |
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