Faith Family Clinic Of Kossuth, Llc | |
820 Highway 2 Corinth MS 38834-7954 | |
(662) 728-0162 | |
(662) 728-0326 |
Full Name | Faith Family Clinic Of Kossuth, Llc |
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Speciality | Clinic/Center |
Location | 820 Highway 2, Corinth, Mississippi |
Authorized Official Name and Position | Kelly S Thornton (CO-OWNER/PROVIDER) |
Authorized Official Contact | 6627280162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Faith Family Clinic Of Kossuth, Llc 820 Highway 2 Corinth MS 38834-7954 Ph: (662) 728-0162 | Faith Family Clinic Of Kossuth, Llc 820 Highway 2 Corinth MS 38834-7954 Ph: (662) 728-0162 |
NPI Number | 1669810636 |
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Provider Enumeration Date | 06/11/2013 |
Last Update Date | 06/11/2013 |
Medicare PECOS PAC ID | 7113161530 |
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Medicare Enrollment ID | O20130924000837 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669810636 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Kelly Thornton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750492203 PECOS PAC ID: 1456317692 Enrollment ID: I20041208001031 |
Provider Name | Victoria P Switcher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679107650 PECOS PAC ID: 4284063421 Enrollment ID: I20200409000053 |
Provider Name | William Fowler Quinn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861277964 PECOS PAC ID: 3971950577 Enrollment ID: I20231102003928 |
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