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845 S Madison St Tupelo MS 38801-4905 | |
(662) 377-1100 | |
(662) 377-1065 |
Full Name | |
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Speciality | Internal Medicine |
Location | 845 S Madison St, Tupelo, Mississippi |
Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623774229 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-2386 | 845 S Madison St Tupelo MS 38801-4905 Ph: (662) 377-1100 |
NPI Number | 1164203360 |
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Provider Enumeration Date | 10/12/2023 |
Last Update Date | 01/21/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164203360 | NPI | - | NPPES |
200006609 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-2386 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |