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10319 Diberville Blvd Diberville MS 39540-2506 | |
(228) 396-2999 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 10319 Diberville Blvd, Diberville, Mississippi |
Authorized Official Name and Position | Chris Anderson (CEO) |
Authorized Official Contact | 2284977908 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2101 Highway 90 Gautier MS 39553-5340 Ph: () - | 10319 Diberville Blvd Diberville MS 39540-2506 Ph: (228) 396-2999 |
NPI Number | 1326233149 |
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Provider Enumeration Date | 09/14/2007 |
Last Update Date | 06/24/2008 |
Identifier | Type | State | Issuer |
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1326233149 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Resolute Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4347 W Gay Rd, Diberville, MS 39540 Phone: 228-229-7989 | |
D'iberville Medical Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11516 Lamey Bridge Rd, Ste 1, Diberville, MS 39540 Phone: 228-207-4190 Fax: 228-207-4190 |