| Fast Pace Mississippi, Pllc | |
|
533 Lake St Hazlehurst MS 39083-2217 | |
| (601) 552-5253 | |
| Not Available |
| Full Name | Fast Pace Mississippi, Pllc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 533 Lake St, Hazlehurst, Mississippi |
| Authorized Official Name and Position | Sydni Clemmons (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9013511791 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fast Pace Mississippi, Pllc Po Box 306415 Nashville TN 37230-6415 Ph: () - | Fast Pace Mississippi, Pllc 533 Lake St Hazlehurst MS 39083-2217 Ph: (601) 552-5253 |
| NPI Number | 1912664293 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912664293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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