Greenwood Primary Care Clinic | |
102 Professional Pl Greenwood MS 38930-9633 | |
(662) 453-1852 | |
Not Available |
Full Name | Greenwood Primary Care Clinic |
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Speciality | Clinic/Center |
Location | 102 Professional Pl, 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 |
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Greenwood Primary Care Clinic Po Box 1410 Greenwood MS 38935-1410 Ph: (662) 453-1852 | Greenwood Primary Care Clinic 102 Professional Pl Greenwood MS 38930-9633 Ph: (662) 453-1852 |
NPI Number | 1548616832 |
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Provider Enumeration Date | 05/05/2016 |
Last Update Date | 01/14/2022 |
Medicare PECOS PAC ID | 1153617402 |
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Medicare Enrollment ID | O20160913000502 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548616832 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | William B Jones |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407948284 PECOS PAC ID: 8123016060 Enrollment ID: I20040504001330 |
Provider Name | Sabrina B Matthews |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043662430 PECOS PAC ID: 7416953047 Enrollment ID: I20160913000669 |
Provider Name | Carrie D Narmour |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477007763 PECOS PAC ID: 4981988300 Enrollment ID: I20170303000789 |
Provider Name | Andrew John Bartlett |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1477932770 PECOS PAC ID: 5597071720 Enrollment ID: I20180413000921 |
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