| |
498 Highway 80 E Clinton MS 39056-4720 | |
(601) 924-4000 | |
(601) 924-3360 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 498 Highway 80 E, Clinton, Mississippi |
Authorized Official Name and Position | Sam Scott (CFO) |
Authorized Official Contact | 6018987525 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
498 Highway 80 E Clinton MS 39056-4720 Ph: (601) 924-4000 | 498 Highway 80 E Clinton MS 39056-4720 Ph: (601) 924-4000 |
NPI Number | 1376577379 |
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Provider Enumeration Date | 07/10/2006 |
Last Update Date | 02/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376577379 | NPI | - | NPPES |
09015301 | Medicaid | MS | |
CH9760 | Other | MS | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Mississippi) | Primary |
Clinton Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Highway 80 E, Suite D, Clinton, MS 39056 Phone: 318-791-3765 Fax: 877-747-5326 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 498 Highway 80 E, Clinton, MS 39056 Phone: 601-924-4000 | |