| Internal Medicine Primary Care Pa | |
|
140 Daughdrill Sta Flowood MS 39232-8406 | |
| (601) 519-0509 | |
| Not Available |
| Full Name | Internal Medicine Primary Care Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 140 Daughdrill Sta, Flowood, Mississippi |
| Authorized Official Name and Position | Imad Tahboub (OWNER) |
| Authorized Official Contact | 6015190509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Primary Care Pa 140 Daughdrill Sta Flowood MS 39232-8406 Ph: (601) 519-0509 | Internal Medicine Primary Care Pa 140 Daughdrill Sta Flowood MS 39232-8406 Ph: (601) 519-0509 |
| NPI Number | 1629542832 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 01/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629542832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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