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1 Medical Ln Ste B Forest MS 39074-4039 | |
(601) 469-4861 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1 Medical Ln Ste B, Forest, Mississippi |
Authorized Official Name and Position | John P Lee (COB) |
Authorized Official Contact | 6014694861 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Pioneer Way Magee MS 39111-5501 Ph: (601) 849-6440 | 1 Medical Ln Ste B Forest MS 39074-4039 Ph: (601) 469-4861 |
NPI Number | 1649761685 |
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Provider Enumeration Date | 05/25/2018 |
Last Update Date | 05/26/2020 |
Identifier | Type | State | Issuer |
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1649761685 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Forest Family Practice Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Ln, Forest, MS 39074 Phone: 601-469-4861 Fax: 601-469-4828 | |
Independent Healthcare Management, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 516 Airport Rd, Forest, MS 39074 Phone: 601-469-4151 Fax: 601-469-3681 | |