| Magnolia Medical Center | |
|
3612 Groveland Rd Ocean Springs MS 39564 | |
| (228) 872-5551 | |
| Not Available |
| Full Name | Magnolia Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 3612 Groveland Rd, Ocean Springs, Mississippi |
| Authorized Official Name and Position | Evan L Summers (OWNER) |
| Authorized Official Contact | 2288725551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Medical Center Po Box 1797 Ocean Springs MS 39566-1797 Ph: (228) 872-5551 | Magnolia Medical Center 3612 Groveland Rd Ocean Springs MS 39564 Ph: (228) 872-5551 |
| NPI Number | 1588660674 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588660674 | NPI | - | NPPES |
| 09015939 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16638 (Mississippi) | Primary |
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