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22741 Bowling Green Rd Lexington MS 39095 | |
(662) 834-1961 | |
(662) 834-1962 |
Full Name | |
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Speciality | Clinic/center |
Location | 22741 Bowling Green Rd, Lexington, Mississippi |
Authorized Official Name and Position | Shelia Ann Snow (OFFICE MANAGER) |
Authorized Official Contact | 6628341961 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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22741 Hwy 12 Bowling Green Rd Lexington MS 39095 Ph: (662) 834-1961 | 22741 Bowling Green Rd Lexington MS 39095 Ph: (662) 834-1961 |
NPI Number | 1942536552 |
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Provider Enumeration Date | 11/02/2009 |
Last Update Date | 03/01/2011 |
Identifier | Type | State | Issuer |
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1942536552 | NPI | - | NPPES |
00115622 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 14192 (Mississippi) | Primary |
Mallory Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |