| Integrated Medical And Wellness Clinic Of Mississippi Llc | |
|
212 Draperton Ct Ridgeland MS 39157-3905 | |
| (769) 300-9040 | |
| (769) 300-9055 |
| Full Name | Integrated Medical And Wellness Clinic Of Mississippi Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 212 Draperton Ct, Ridgeland, Mississippi |
| Authorized Official Name and Position | David F. Rowe (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2282480561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medical And Wellness Clinic Of Mississippi Llc 2556 Marcia Ct Biloxi MS 39531-2352 Ph: (228) 248-0561 | Integrated Medical And Wellness Clinic Of Mississippi Llc 212 Draperton Ct Ridgeland MS 39157-3905 Ph: (769) 300-9040 |
| NPI Number | 1104580943 |
|---|---|
| Provider Enumeration Date | 10/27/2021 |
| Last Update Date | 10/29/2021 |
| Medicare PECOS PAC ID | 2163852005 |
|---|---|
| Medicare Enrollment ID | O20211123001463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104580943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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