Louisville Medical Clinic | |
14724 Highway 15 N Louisville MS 39339-6318 | |
(662) 773-7500 | |
Not Available |
Full Name | Louisville Medical Clinic |
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Speciality | Clinic/Center |
Location | 14724 Highway 15 N, Louisville, Mississippi |
Authorized Official Name and Position | Susan Hollingsworth Wells (ADMINISTRATOR) |
Authorized Official Contact | 6622859460 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Louisville Medical Clinic 8613 Ms Highway 12 Ackerman MS 39735-8917 Ph: (662) 285-9460 | Louisville Medical Clinic 14724 Highway 15 N Louisville MS 39339-6318 Ph: (662) 773-7500 |
NPI Number | 1538555347 |
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Provider Enumeration Date | 04/08/2015 |
Last Update Date | 04/20/2022 |
Medicare PECOS PAC ID | 2567682206 |
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Medicare Enrollment ID | O20150522000115 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538555347 | NPI | - | NPPES |
01771892 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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