| Gough's Family And Pediatric Clinic | |
|
189 N Main St Drew MS 38737-3146 | |
| (662) 745-6638 | |
| (662) 745-8480 |
| Full Name | Gough's Family And Pediatric Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 189 N Main St, Drew, Mississippi |
| Authorized Official Name and Position | Walter Gough (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6627456638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gough's Family And Pediatric Clinic Po Box 68 Drew MS 38737-0068 Ph: (662) 745-6638 | Gough's Family And Pediatric Clinic 189 N Main St Drew MS 38737-3146 Ph: (662) 745-6638 |
| NPI Number | 1528306222 |
|---|---|
| Provider Enumeration Date | 01/30/2013 |
| Last Update Date | 01/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528306222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 06639 (Mississippi) | Primary |
Dhc-a W James Elementary School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 South Blvd, Drew, MS 38737 Phone: 662-745-8892 Fax: 662-745-6228 | |
Making Moves In The Community, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 N Main St, Drew, MS 38737 Phone: 662-745-6638 |