| Mcclendon Medical Clinic Pllc | |
|
22c Doctors Dr Ocean Springs MS 39564-5721 | |
| (601) 906-2701 | |
| Not Available |
| Full Name | Mcclendon Medical Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 22c Doctors Dr, Ocean Springs, Mississippi |
| Authorized Official Name and Position | William David Mcclendon (OWNER) |
| Authorized Official Contact | 6019062701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcclendon Medical Clinic Pllc 22c Doctors Dr Ocean Springs MS 39564-5721 Ph: (601) 906-2701 | Mcclendon Medical Clinic Pllc 22c Doctors Dr Ocean Springs MS 39564-5721 Ph: (601) 906-2701 |
| NPI Number | 1053782755 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 05/10/2023 |
| Medicare PECOS PAC ID | 6103129945 |
|---|---|
| Medicare Enrollment ID | O20160128000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053782755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 8249 (Mississippi) | Primary |
| Provider Name | William D Mcclendon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790735652 PECOS PAC ID: 5496770208 Enrollment ID: I20051011000678 |
| Provider Name | Kelly L Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871933994 PECOS PAC ID: 2062655459 Enrollment ID: I20130904000719 |
| Provider Name | Elizabeth Foster Brushaber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477144939 PECOS PAC ID: 9537553383 Enrollment ID: I20220222000957 |
| Provider Name | Hart Katherine Wylie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053639088 PECOS PAC ID: 3375818206 Enrollment ID: I20230125000528 |
| Provider Name | Brianna Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679962765 PECOS PAC ID: 4789900341 Enrollment ID: I20230928000479 |
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