| Moss Point Family Clinic | |
|
5430 Griffin St Moss Point MS 39563-2003 | |
| (228) 355-0719 | |
| (228) 475-4039 |
| Full Name | Moss Point Family Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5430 Griffin St, Moss Point, Mississippi |
| Authorized Official Name and Position | William Sidney Robert Ross (OWNER) |
| Authorized Official Contact | 2283550719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moss Point Family Clinic 5430 Griffin St Moss Point MS 39563-2003 Ph: (228) 355-0719 | Moss Point Family Clinic 5430 Griffin St Moss Point MS 39563-2003 Ph: (228) 355-0719 |
| NPI Number | 1518172568 |
|---|---|
| Provider Enumeration Date | 05/13/2007 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518172568 | NPI | - | NPPES |
| DG3268 | Other | MS | RAILROAD MEDICARE |
| 1972617884 | Other | MS | PERSONAL NPI NUMBER FOR M |
| 0115091 | Medicaid | MS | |
| 01903811 | Medicaid | MS | |
| 1710955869 | Other | MS | PA GRAY'S NPI |
| 296723832 | Other | MS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 12739 (Mississippi) | Primary |
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