| Macon Medical Clinic | |
|
602 N. Jefferson St. Macon MS 39341 | |
| (662) 726-5831 | |
| (662) 726-4638 |
| Full Name | Macon Medical Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 602 N. Jefferson St., Macon, Mississippi |
| Authorized Official Name and Position | Ernest Roy Stuart (PRESIDENT) |
| Authorized Official Contact | 6627265831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Macon Medical Clinic 602 N. Jefferson St. P.o. Box 306 Macon MS 39341 Ph: (662) 726-5831 | Macon Medical Clinic 602 N. Jefferson St. Macon MS 39341 Ph: (662) 726-5831 |
| NPI Number | 1093880874 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093880874 | NPI | - | NPPES |
| 09014931 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 258944 (Mississippi) | Primary |
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