| Fast Pace Mississippi, PLLC | |
|
616 Highway 82 W Indianola MS 38751-2035 | |
| (931) 253-1101 | |
| (931) 722-9919 |
| Full Name | Fast Pace Mississippi, PLLC |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 616 Highway 82 W, Indianola, 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: (931) 253-1101 | Fast Pace Mississippi, PLLC 616 Highway 82 W Indianola MS 38751-2035 Ph: (931) 253-1101 |
| NPI Number | 1881353597 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 12/09/2021 |
| Certification Date | 12/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881353597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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