| |
102 Clinton Pkwy Third Floor Clinton MS 39056-4730 | |
(601) 924-9750 | |
(601) 925-9125 |
Full Name | |
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Speciality | Clinic/center |
Location | 102 Clinton Pkwy, Clinton, Mississippi |
Authorized Official Name and Position | John H Mcvey (MANAGING PARTNER) |
Authorized Official Contact | 6013532020 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1190 N State St Suite 403 Jackson MS 39202-2413 Ph: (601) 353-2020 | 102 Clinton Pkwy Third Floor Clinton MS 39056-4730 Ph: (601) 924-9750 |
NPI Number | 1184671489 |
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Provider Enumeration Date | 05/30/2006 |
Last Update Date | 04/01/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184671489 | NPI | - | NPPES |
03189030 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 20061221 (Mississippi) | Primary |
Clinton Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Highway 80 E, Suite D, Clinton, MS 39056 Phone: 318-791-3765 Fax: 877-747-5326 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 498 Highway 80 E, Clinton, MS 39056 Phone: 601-924-4000 | |