| Internal Medicine Group Of The Midsouth Pllc | |
|
391 Southcrest Cl Suite 210 Southaven MS 38671 | |
| (662) 536-1520 | |
| Not Available |
| Full Name | Internal Medicine Group Of The Midsouth Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 391 Southcrest Cl, Southaven, Mississippi |
| Authorized Official Name and Position | Aileen S Gayoso (PRESIDENT) |
| Authorized Official Contact | 6625361520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Group Of The Midsouth Pllc 391 Southcrest Cl 210 Southaven MS 38671 Ph: (662) 536-1520 | Internal Medicine Group Of The Midsouth Pllc 391 Southcrest Cl Suite 210 Southaven MS 38671 Ph: (662) 536-1520 |
| NPI Number | 1609035468 |
|---|---|
| Provider Enumeration Date | 06/06/2008 |
| Last Update Date | 06/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609035468 | NPI | - | NPPES |
| 160334001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 15680 (Mississippi) | Primary |
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