Family Medical Clinic Vardaman | |
310 W Sweet Potato St Ste B Vardaman MS 38878-8405 | |
(662) 567-1282 | |
Not Available |
Full Name | Family Medical Clinic Vardaman |
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Speciality | Clinic/Center |
Location | 310 W Sweet Potato St Ste B, Vardaman, Mississippi |
Authorized Official Name and Position | Jana Earnest (OFFICE MANAGER) |
Authorized Official Contact | 6625671283 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Medical Clinic Vardaman Po Box 207 Vardaman MS 38878-0207 Ph: (662) 567-1283 | Family Medical Clinic Vardaman 310 W Sweet Potato St Ste B Vardaman MS 38878-8405 Ph: (662) 567-1282 |
NPI Number | 1467177683 |
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Provider Enumeration Date | 10/10/2022 |
Last Update Date | 02/09/2023 |
Medicare PECOS PAC ID | 1052789302 |
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Medicare Enrollment ID | O20221117002993 |
Identifier | Type | State | Issuer |
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1467177683 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Joy Anita Chapman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427064344 PECOS PAC ID: 5193727972 Enrollment ID: I20070207000344 |
Provider Name | James M Orender |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1538263058 PECOS PAC ID: 0648212282 Enrollment ID: I20101013000836 |
Provider Name | Amanda Brand Mahan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720562226 PECOS PAC ID: 0840544573 Enrollment ID: I20181116000679 |