| Inspired Health Clinic | |
|
1016 Mission 66 Vicksburg MS 39183-2752 | |
| (601) 876-7003 | |
| Not Available |
| Full Name | Inspired Health Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1016 Mission 66, Vicksburg, Mississippi |
| Authorized Official Name and Position | Shinita Reed Dudley (OWNER) |
| Authorized Official Contact | 6012137681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspired Health Clinic Po Box 550 Clinton MS 39060-0550 Ph: (601) 876-7003 | Inspired Health Clinic 1016 Mission 66 Vicksburg MS 39183-2752 Ph: (601) 876-7003 |
| NPI Number | 1336866615 |
|---|---|
| Provider Enumeration Date | 10/26/2022 |
| Last Update Date | 01/31/2023 |
| Medicare PECOS PAC ID | 4587036868 |
|---|---|
| Medicare Enrollment ID | O20230215000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336866615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
| Provider Name | Shinita Reed Dudley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154354603 PECOS PAC ID: 0547152696 Enrollment ID: I20040325000821 |
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