| Indianola Clinic, Llc | |
|
201 Baker Blvd Leland MS 38756-3401 | |
| (662) 686-4121 | |
| (662) 686-4770 |
| Full Name | Indianola Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 201 Baker Blvd, Leland, Mississippi |
| Authorized Official Name and Position | Henry Marlin Womack (VP OF ADMINISTRATION) |
| Authorized Official Contact | 6626864121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indianola Clinic, Llc 201 Baker Blvd Leland MS 38756-3401 Ph: (662) 686-4121 | Indianola Clinic, Llc 201 Baker Blvd Leland MS 38756-3401 Ph: (662) 686-4121 |
| NPI Number | 1902906258 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902906258 | NPI | - | NPPES |
| 00459821 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Delta Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Baker Blvd, Leland, MS 38756 Phone: 662-686-4121 | |
Delta Health Alliance, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Baker Blvd, Leland, MS 38756 Phone: 662-686-4121 Fax: 662-686-4770 | |
Delta Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 801 N Broad St, Leland, MS 38756 Phone: 662-741-8800 Fax: 662-741-2700 | |
Leland Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Baker Blvd, Leland, MS 38756 Phone: 662-686-4121 Fax: 662-686-4770 | |
Leland Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Baker Blvd, Leland, MS 38756 Phone: 662-686-4121 Fax: 662-686-4770 |