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820 Mangum Ave Mendenhall MS 39114 | |
| (601) 847-5066 | |
| (601) 847-0149 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 820 Mangum Ave, Mendenhall, Mississippi |
| Authorized Official Name and Position | Amnuey M Chiemprabha (PRESIDENT) |
| Authorized Official Contact | 6018475066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 295 Mendenhall MS 39114 Ph: (601) 847-5066 | 820 Mangum Ave Mendenhall MS 39114 Ph: (601) 847-5066 |
| NPI Number | 1346300423 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 05/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346300423 | NPI | - | NPPES |
| 01722227 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 08142 (Mississippi) | Primary |
| 208600000X | Surgery | 08142 (Mississippi) | Secondary |
Mendenhall Medical Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3661 Simpson Highway 49, Mendenhall, MS 39114 Phone: 601-292-9350 Fax: 601-292-9351 | |
121 Medical Place, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 820 Mangum Ave, Mendenhall, MS 39114 Phone: 601-906-1897 | |
Simpson Community Healthcare Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1827a Simpson Highway 149, Mendenhall, MS 39114 Phone: 601-847-7130 | |
Holbrook Family Medical Practice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Oak St, Mendenhall, MS 39114 Phone: 601-847-3712 |