| |
1515 Jefferson St Laurel MS 39440-4244 | |
(601) 425-4893 | |
(601) 428-8633 |
Full Name | |
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Speciality | Family Medicine |
Location | 1515 Jefferson St, Laurel, Mississippi |
Authorized Official Name and Position | Sam Scott (CFO) |
Authorized Official Contact | 6018987535 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1515 Jefferson St Laurel MS 39440-4244 Ph: (601) 425-4893 | 1515 Jefferson St Laurel MS 39440-4244 Ph: (601) 425-4893 |
NPI Number | 1407880404 |
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Provider Enumeration Date | 07/10/2006 |
Last Update Date | 02/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407880404 | NPI | - | NPPES |
09015301 | Medicaid | MS | |
CH0373 | Other | MS | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Mississippi) | Primary |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-428-6561 | |
Jefferson Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 | |