| Greenwood Children's Clinic | |
|
1405 Strong Ave Greenwood MS 38930 | |
| (662) 459-7030 | |
| Not Available |
| Full Name | Greenwood Children's Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1405 Strong Ave, Greenwood, Mississippi |
| Authorized Official Name and Position | Dawne Holmes (CFO) |
| Authorized Official Contact | 6624597119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenwood Children's Clinic Po Box 1410 Clinic Administration Greenwood MS 38935-1410 Ph: (662) 459-7030 | Greenwood Children's Clinic 1405 Strong Ave Greenwood MS 38930 Ph: (662) 459-7030 |
| NPI Number | 1669441994 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 06/24/2020 |
| Medicare PECOS PAC ID | 8224221619 |
|---|---|
| Medicare Enrollment ID | O20101018001016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669441994 | NPI | - | NPPES |
| 09015045 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Shandra C Mcclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538138250 PECOS PAC ID: 1052395662 Enrollment ID: I20040614000226 |
| Provider Name | Billy Boldon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790754000 PECOS PAC ID: 6507051992 Enrollment ID: I20101111000125 |
| Provider Name | Claudine Stevens |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225007537 PECOS PAC ID: 1759576150 Enrollment ID: I20101111000170 |
| Provider Name | Vivan Elizabeth Huddleston |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093784209 PECOS PAC ID: 7517152549 Enrollment ID: I20101116000384 |
| Provider Name | Dawn C Peery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871844498 PECOS PAC ID: 4082853627 Enrollment ID: I20130612000143 |
Dr. Arenia C. Mallory Community Health Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 East Washington Street, Greenwood, MS 38930 Phone: 662-453-4522 Fax: 662-453-4518 | |
Gorton Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 River Rd, Attn Clinic Administration, Greenwood, MS 38930 Phone: 662-459-7189 Fax: 662-459-1147 | |
Leflore Specialty Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 River Rd, Greenwood, MS 38930 Phone: 662-451-7881 | |
Greenwood Comprehensive Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 517 Highway 82 W, Greenwood, MS 38930 Phone: 662-455-6767 Fax: 662-455-1774 | |
Michael T. Boler, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Walthall St, Greenwood, MS 38930 Phone: 662-453-5331 Fax: 662-453-5332 | |
State Of Mississippi - University Of Mississippi Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 9th St, Greenwood, MS 38930 Phone: 662-227-7000 | |
Dr Charles L Nause Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 E Market St, Greenwood, MS 38930 Phone: 662-453-5460 Fax: 662-453-5551 |