| Mid South Wellness Center, Inc | |
|
7662 Highway 51north Suite 2 Millington TN 38053 | |
| (901) 873-2555 | |
| (901) 873-2561 |
| Full Name | Mid South Wellness Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7662 Highway 51north, Millington, Tennessee |
| Authorized Official Name and Position | Jerry Ray Floyd (OWNER) |
| Authorized Official Contact | 9018732555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid South Wellness Center, Inc 7662 Highway 51north Suite 2 Millington TN 38053 Ph: (901) 873-2555 | Mid South Wellness Center, Inc 7662 Highway 51north Suite 2 Millington TN 38053 Ph: (901) 873-2555 |
| NPI Number | 1932258787 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 12/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932258787 | NPI | - | NPPES |
| 3378384 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000028821 (Tennessee) | Primary |
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