| Crossroads Health Clinic, P.a. | |
|
1801 S Harper Rd Ste 7 Corinth MS 38834-6726 | |
| (662) 286-2300 | |
| (662) 286-7010 |
| Full Name | Crossroads Health Clinic, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1801 S Harper Rd Ste 7, Corinth, Mississippi |
| Authorized Official Name and Position | Debora Mcfalls (PRESIDENT) |
| Authorized Official Contact | 6622862300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Health Clinic, P.a. 1801 S Harper Rd Ste 7 Corinth MS 38834-6726 Ph: (662) 286-2300 | Crossroads Health Clinic, P.a. 1801 S Harper Rd Ste 7 Corinth MS 38834-6726 Ph: (662) 286-2300 |
| NPI Number | 1932139169 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 9234196411 |
|---|---|
| Medicare Enrollment ID | O20050425000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932139169 | NPI | - | NPPES |
| 00656871 | Medicaid | MS | |
| R582662 | Other | MS | NURSE LICENSE # |
| 0121943 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 258980 (Mississippi) | Primary |
| Provider Name | Debora F Mcfalls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386679579 PECOS PAC ID: 6800878356 Enrollment ID: I20040719001384 |
| Provider Name | Ralph Condon Hughes |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1598898967 PECOS PAC ID: 9234029968 Enrollment ID: I20080822000459 |
| Provider Name | Mary E Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316487994 PECOS PAC ID: 7214214246 Enrollment ID: I20170501000777 |
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