| Newsom Healthcare Of Desoto County, Llc | |
|
2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291 | |
| (662) 393-8022 | |
| (662) 393-8052 |
| Full Name | Newsom Healthcare Of Desoto County, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2906 Goodman Rd W, Horn Lake, Mississippi |
| Authorized Official Name and Position | Sandra Matthews Newsom (OWNER/PRESIDENT) |
| Authorized Official Contact | 6623938022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newsom Healthcare Of Desoto County, Llc 2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291 Ph: (662) 393-8022 | Newsom Healthcare Of Desoto County, Llc 2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291 Ph: (662) 393-8022 |
| NPI Number | 1205243649 |
|---|---|
| Provider Enumeration Date | 07/17/2014 |
| Last Update Date | 07/22/2014 |
| Medicare PECOS PAC ID | 1759609340 |
|---|---|
| Medicare Enrollment ID | O20150410001254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205243649 | NPI | - | NPPES |
| 00117535 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R852706 (Mississippi) | Primary |
| Provider Name | Sandra M Newsom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912901521 PECOS PAC ID: 7618037458 Enrollment ID: I20090127000439 |
| Provider Name | Penny Marie Holley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013524495 PECOS PAC ID: 4082024492 Enrollment ID: I20201112002857 |
Southern Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6426 Highway 51 N, Horn Lake, MS 38637 Phone: 662-342-4080 Fax: 662-342-4933 | |
Horn Lake Chiropractic Centre, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 Goodman Rd W, Horn Lake, MS 38637 Phone: 662-342-5368 Fax: 662-342-7980 | |
Superior Health And Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2085 Goodman Rd W, Horn Lake, MS 38637 Phone: 662-253-8459 Fax: 662-253-8678 | |
Horn Lake Family Practice Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3102 Goodman Rd W, Horn Lake, MS 38637 Phone: 662-342-6677 Fax: 662-342-1213 | |
Convenient Care Clinic, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3040 Goodman Rd West, Horn Lake, MS 38637 Phone: 662-578-2030 Fax: 615-301-6550 | |
Comprehensive Family Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3040 Goodman Rd W, Horn Lake, MS 38637 Phone: 662-280-3428 Fax: 662-280-1736 |