Greenville Family Clinic | |
867 Mississippi St Greenville MS 38701-5963 | |
(662) 378-0283 | |
(662) 332-3316 |
Full Name | Greenville Family Clinic |
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Speciality | Family Medicine |
Location | 867 Mississippi St, Greenville, Mississippi |
Authorized Official Name and Position | Pam G Maddox (OFFICE MANAGER) |
Authorized Official Contact | 6623780283 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Greenville Family Clinic 867 Mississippi St Greenville MS 38701-5963 Ph: () - | Greenville Family Clinic 867 Mississippi St Greenville MS 38701-5963 Ph: (662) 378-0283 |
NPI Number | 1598946667 |
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Provider Enumeration Date | 11/16/2007 |
Last Update Date | 01/26/2012 |
Medicare PECOS PAC ID | 7012177496 |
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Medicare Enrollment ID | O20120321000741 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598946667 | NPI | - | NPPES |
09013355 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 11843 (Mississippi) | Primary |
Provider Name | Bill Franklin Maddox |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1225256381 PECOS PAC ID: 6608036041 Enrollment ID: I20120322000436 |
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