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845 S Madison St Tupelo MS 38801-4905 | |
(662) 377-5930 | |
(662) 377-5085 |
Full Name | |
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Speciality | Internal Medicine |
Location | 845 S Madison St, Tupelo, Mississippi |
Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623774229 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-2774 | 845 S Madison St Tupelo MS 38801-4905 Ph: (662) 377-5930 |
NPI Number | 1437254836 |
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Provider Enumeration Date | 09/13/2006 |
Last Update Date | 01/21/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437254836 | NPI | - | NPPES |
009014876 | Medicaid | MS | |
529902070 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RR0500X | Internal Medicine - Rheumatology | (* (Not Available)) | Secondary |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-2386 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |