| Ecru Medical Clinic | |
|
202 Main Street Ecru MS 38841 | |
| (662) 489-4345 | |
| (662) 489-8975 |
| Full Name | Ecru Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 202 Main Street, Ecru, Mississippi |
| Authorized Official Name and Position | Gerald Kimbrough (MANAGER) |
| Authorized Official Contact | 6623774685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecru Medical Clinic 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | Ecru Medical Clinic 202 Main Street Ecru MS 38841 Ph: (662) 489-4345 |
| NPI Number | 1477665107 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477665107 | NPI | - | NPPES |
| 09014823 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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