Hickory Flat Clinic, Llc | |
250 Oak St Hickory Flat MS 38633 | |
(662) 551-6492 | |
Not Available |
Full Name | Hickory Flat Clinic, Llc |
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Speciality | Clinic/Center |
Location | 250 Oak St, Hickory Flat, Mississippi |
Authorized Official Name and Position | Stephanie Thompson (FNP) |
Authorized Official Contact | 6625516492 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hickory Flat Clinic, Llc 6492 Beck Springs Rd Hickory Flat MS 38633-9116 Ph: () - | Hickory Flat Clinic, Llc 250 Oak St Hickory Flat MS 38633 Ph: (662) 551-6492 |
NPI Number | 1326380189 |
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Provider Enumeration Date | 03/20/2013 |
Last Update Date | 03/20/2013 |
Medicare PECOS PAC ID | 9032332762 |
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Medicare Enrollment ID | O20140527000216 |
Identifier | Type | State | Issuer |
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1326380189 | NPI | - | NPPES |
09426886 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | R855906 (Mississippi) | Primary |
Provider Name | Stephanie E Thompson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811150402 PECOS PAC ID: 8123213709 Enrollment ID: I20101109000451 |
Hickory Flat Clinic Association Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Oak St, Hickory Flat, MS 38633 Phone: 662-333-6387 Fax: 662-333-6725 |