| Grenada Lake Inpatient Medicine Associates | |
|
960 J K Avent Dr Grenada MS 38901-5230 | |
| (662) 227-7492 | |
| (662) 227-7541 |
| Full Name | Grenada Lake Inpatient Medicine Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 960 J K Avent Dr, Grenada, Mississippi |
| Authorized Official Name and Position | Keith Heartsill (CFO) |
| Authorized Official Contact | 6622277172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grenada Lake Inpatient Medicine Associates Po Box 52007 Atlanta GA 30355-0007 Ph: (678) 397-0060 | Grenada Lake Inpatient Medicine Associates 960 J K Avent Dr Grenada MS 38901-5230 Ph: (662) 227-7492 |
| NPI Number | 1235284928 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235284928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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