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65 Lakeview Dr Clinton MS 39056-5221 | |
(601) 924-1744 | |
(601) 924-7406 |
Full Name | |
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Speciality | Family Medicine |
Location | 65 Lakeview Dr, Clinton, Mississippi |
Authorized Official Name and Position | Kirby J Orme (OWNER) |
Authorized Official Contact | 6019514048 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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123a Highway 80 E # 243 Clinton MS 39056-4738 Ph: (601) 951-4048 | 65 Lakeview Dr Clinton MS 39056-5221 Ph: (601) 924-1744 |
NPI Number | 1154406270 |
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Provider Enumeration Date | 10/26/2006 |
Last Update Date | 06/05/2020 |
Identifier | Type | State | Issuer |
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1154406270 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | 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 | |