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1017 Jackson Ave Leakesville MS 39451-9105 | |
(601) 394-4135 | |
(601) 394-4455 |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 1017 Jackson Ave, Leakesville, Mississippi |
Authorized Official Name and Position | Odessa Glynn (BUSINESS OFFICE DIRECTOR) |
Authorized Official Contact | 6013944135 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1017 Jackson Ave Leakesville MS 39451-9105 Ph: (601) 394-4135 | 1017 Jackson Ave Leakesville MS 39451-9105 Ph: (601) 394-4135 |
NPI Number | 1992982805 |
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Provider Enumeration Date | 01/23/2008 |
Last Update Date | 07/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992982805 | NPI | - | NPPES |
02255270 | Medicaid | MS | |
04428516 | Medicaid | MS | |
06200741 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | 11343 (Mississippi) | Primary |
Greene County Clinic Hospital Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1017 Jackson Ave, Leakesville, MS 39451 Phone: 601-947-8181 Fax: 601-947-4411 | |
Greene County Family Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1017 Jackson Ave, Leakesville, MS 39451 Phone: 601-394-2820 Fax: 601-394-2827 | |
Coastal Family Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 951 Main St, Leakesville, MS 39451 Phone: 601-394-2381 Fax: 601-394-2593 |