| Ms Magnolia Medical,llc | |
|
516 N Magnolia St Laurel MS 39440-3559 | |
| (601) 422-5990 | |
| Not Available |
| Full Name | Ms Magnolia Medical,llc |
|---|---|
| Speciality | General Practice |
| Location | 516 N Magnolia St, Laurel, Mississippi |
| Authorized Official Name and Position | Brittany A Ratcliff (CREDENTIALING) |
| Authorized Official Contact | 6014335679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Magnolia Medical,llc 516 N Magnolia St Laurel MS 39440-3559 Ph: (601) 342-5901 | Ms Magnolia Medical,llc 516 N Magnolia St Laurel MS 39440-3559 Ph: (601) 422-5990 |
| NPI Number | 1386304129 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 07/22/2022 |
| Medicare PECOS PAC ID | 5799166344 |
|---|---|
| Medicare Enrollment ID | O20220714000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386304129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Tomia D Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275587206 PECOS PAC ID: 9638495252 Enrollment ID: I20170309002144 |
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