Durant Primary Care Clinic | |
638 Northwest Ave Durant MS 39063-3337 | |
(662) 653-1002 | |
(662) 653-1038 |
Full Name | Durant Primary Care Clinic |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 638 Northwest Ave, Durant, Mississippi |
Authorized Official Name and Position | Elias Abboud (OWNER) |
Authorized Official Contact | 6626531002 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Durant Primary Care Clinic 638 Northwest Ave Durant MS 39063-3337 Ph: (662) 653-1002 | Durant Primary Care Clinic 638 Northwest Ave Durant MS 39063-3337 Ph: (662) 653-1002 |
NPI Number | 1124100813 |
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Provider Enumeration Date | 10/20/2006 |
Last Update Date | 09/29/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124100813 | NPI | - | NPPES |
01824892 | Medicaid | MS | |
09807861 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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