| Magnolia Internal Medical Clinic | |
|
5 River Bend Pl Suite C Flowood MS 39232-7618 | |
| (601) 933-9696 | |
| Not Available |
| Full Name | Magnolia Internal Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 5 River Bend Pl, Flowood, Mississippi |
| Authorized Official Name and Position | Evan L. Summers (PRESIDENT) |
| Authorized Official Contact | 6019339696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Internal Medical Clinic Po Box 321411 Flowood MS 39232-1411 Ph: (601) 933-9696 | Magnolia Internal Medical Clinic 5 River Bend Pl Suite C Flowood MS 39232-7618 Ph: (601) 933-9696 |
| NPI Number | 1467567990 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 07/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467567990 | NPI | - | NPPES |
| 06923312 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16638 (Mississippi) | Primary |
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