Eudora Medical Clinic | |
8995 W Commerce St Ste 4 Hernando MS 38632-6812 | |
(662) 589-6290 | |
(662) 649-6085 |
Full Name | Eudora Medical Clinic |
---|---|
Speciality | Family Medicine |
Location | 8995 W Commerce St Ste 4, Hernando, Mississippi |
Authorized Official Name and Position | Amy M. Perkins (OWNER) |
Authorized Official Contact | 6625896290 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Eudora Medical Clinic 8995 W Commerce St Ste 4 Hernando MS 38632-6812 Ph: (662) 589-6290 | Eudora Medical Clinic 8995 W Commerce St Ste 4 Hernando MS 38632-6812 Ph: (662) 589-6290 |
NPI Number | 1255043493 |
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Provider Enumeration Date | 12/19/2022 |
Last Update Date | 03/06/2023 |
Medicare PECOS PAC ID | 8123490166 |
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Medicare Enrollment ID | O20230221000725 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255043493 | NPI | - | NPPES |
03003882 | Medicaid | MS | |
879057 | Other | MS | MS NURSING/NP LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
Provider Name | Amy M Perkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487903936 PECOS PAC ID: 7113176769 Enrollment ID: I20120926000060 |
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