King's Daughters Primary Care Clinic | |
940 Brookway Blvd Brookhaven MS 39601-2644 | |
(601) 823-5000 | |
Not Available |
Full Name | King's Daughters Primary Care Clinic |
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Speciality | Clinic/Center |
Location | 940 Brookway Blvd, Brookhaven, Mississippi |
Authorized Official Name and Position | Scott Christensen (CEO) |
Authorized Official Contact | 6018359488 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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King's Daughters Primary Care Clinic 427 Highway 51 N Brookhaven MS 39601-2350 Ph: (601) 835-9275 | King's Daughters Primary Care Clinic 940 Brookway Blvd Brookhaven MS 39601-2644 Ph: (601) 823-5000 |
NPI Number | 1003680729 |
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Provider Enumeration Date | 11/13/2023 |
Last Update Date | 11/13/2023 |
Medicare PECOS PAC ID | 3072575539 |
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Medicare Enrollment ID | O20240108004661 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003680729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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