| Holbrook Family Medical Practice, Inc. | |
|
102 Oak St Mendenhall MS 39114-3650 | |
| (601) 847-3712 | |
| Not Available |
| Full Name | Holbrook Family Medical Practice, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 102 Oak St, Mendenhall, Mississippi |
| Authorized Official Name and Position | Chip D Holbrook (OWNER) |
| Authorized Official Contact | 6018473712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holbrook Family Medical Practice, Inc. 102 Oak St Mendenhall MS 39114-3650 Ph: (601) 847-3712 | Holbrook Family Medical Practice, Inc. 102 Oak St Mendenhall MS 39114-3650 Ph: (601) 847-3712 |
| NPI Number | 1760526990 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760526990 | NPI | - | NPPES |
| 587439330D | Other | MS | BLUE CROSS |
| 09015830 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14412 (Mississippi) | Primary |
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