| Family Medical Clinic Of Okolona | |
|
518 West Dr Okolona MS 38860-1624 | |
| (662) 447-6170 | |
| Not Available |
| Full Name | Family Medical Clinic Of Okolona |
|---|---|
| Speciality | Clinic/Center |
| Location | 518 West Dr, Okolona, Mississippi |
| Authorized Official Name and Position | Sheila Brockman (CEO) |
| Authorized Official Contact | 6624563700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Clinic Of Okolona Po Box 432 Houston MS 38851-0432 Ph: (662) 476-1716 | Family Medical Clinic Of Okolona 518 West Dr Okolona MS 38860-1624 Ph: (662) 447-6170 |
| NPI Number | 1134236870 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 0042102352 |
|---|---|
| Medicare Enrollment ID | O20080715000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134236870 | NPI | - | NPPES |
| 253417 | Other | MS | TRISPAN |
| C02044 | Other | MS | MEDICARE PART B GROUP |
| 09014527 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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