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1771 Curtis Drive Iuka MS 38852-1130 | |
| (662) 423-6014 | |
| (662) 423-2972 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 1771 Curtis Drive, Iuka, 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 |
|---|---|
808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-2774 | 1771 Curtis Drive Iuka MS 38852-1130 Ph: (662) 423-6014 |
| NPI Number | 1568567956 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 01/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568567956 | NPI | - | NPPES |
| 009016172 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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