<unavail> in Pontotoc, MS - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Pontotoc, Mississippi. The current practice location for is 11 E Jefferson St, Pontotoc, Mississippi. For appointments, you can reach them via phone at (662) 419-1260. The mailing address for is 131 Emberwood Ct, Tupelo, Mississippi and phone number is (662) 419-1260.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1689456527. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 419-1260.

Contact Information


	11 E Jefferson St Pontotoc MS 38863-2807
	(662) 419-1260
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	11 E Jefferson St, Pontotoc, Mississippi
Authorized Official Name and Position	Jessica Anne Lauderdale (OWNER)
Authorized Official Contact	6624896041
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
131 Emberwood Ct Tupelo MS 38801-7861 Ph: (662) 419-1260	11 E Jefferson St Pontotoc MS 38863-2807 Ph: (662) 419-1260

NPI Details:

NPI Number	1689456527
Provider Enumeration Date	10/16/2023
Last Update Date	03/22/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	2365890175
Medicare Enrollment ID	O20231204002265

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689456527	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Jessica A Lauderdale
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1093095523 PECOS PAC ID: 4082901228 Enrollment ID: I20170111000566

Reviews and Comments

Clinic/Center in Pontotoc, MS

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- Medicare Primary Care in Pontotoc, MS