| Elite Medical, Pllc | |
|
2633 Traceland Dr Tupelo MS 38801-4238 | |
| (662) 205-4652 | |
| (662) 205-4651 |
| Full Name | Elite Medical, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2633 Traceland Dr, Tupelo, Mississippi |
| Authorized Official Name and Position | Anne Dye Haire (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6622054652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical, Pllc Po Box 2484 Tupelo MS 38803-2484 Ph: (662) 205-4652 | Elite Medical, Pllc 2633 Traceland Dr Tupelo MS 38801-4238 Ph: (662) 205-4652 |
| NPI Number | 1871887661 |
|---|---|
| Provider Enumeration Date | 06/08/2011 |
| Last Update Date | 10/22/2013 |
| Medicare PECOS PAC ID | 6204004476 |
|---|---|
| Medicare Enrollment ID | O20110714000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871887661 | NPI | - | NPPES |
| 00126275 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 16935 (Mississippi) | Primary |
| Provider Name | Carole Anne D Haire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922074228 PECOS PAC ID: 3375672454 Enrollment ID: I20100527000790 |
| Provider Name | Malinda M Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245276849 PECOS PAC ID: 7012176514 Enrollment ID: I20120301000690 |
| Provider Name | Ryan C Wiygul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174807135 PECOS PAC ID: 9335301696 Enrollment ID: I20120502000412 |
| Provider Name | Lauren Mcgee Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760536783 PECOS PAC ID: 6204180169 Enrollment ID: I20181112001488 |
South Madison Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040a S. Madison St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
Nmmc Ekg Interpretations Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
North Mississippi Neurosurgical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801 Phone: 662-377-5700 Fax: 662-377-5720 | |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 E President Ave, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 450 E President Ave, Tupelo, MS 38801 Phone: 662-377-4685 | |
Advanced Wound Center Professionals Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801 Phone: 662-377-2395 Fax: 662-377-2397 |