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1031 Northridge Rd Baldwyn MS 38824-1173 | |
(662) 365-9305 | |
(662) 365-9304 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1031 Northridge Rd, Baldwyn, Mississippi |
Authorized Official Name and Position | Anita J Turner (OWNER) |
Authorized Official Contact | 6623659305 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1031 Northridge Rd Baldwyn MS 38824-1173 Ph: (662) 365-9305 | 1031 Northridge Rd Baldwyn MS 38824-1173 Ph: (662) 365-9305 |
NPI Number | 1497820310 |
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Provider Enumeration Date | 11/24/2006 |
Last Update Date | 12/08/2017 |
Medicare PECOS PAC ID | 5294646782 |
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Medicare Enrollment ID | O20030818000030 |
Identifier | Type | State | Issuer |
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1497820310 | NPI | - | NPPES |
06403005 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | R622176 (Mississippi) | Primary |
Waters Family Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Mill St, Baldwyn, MS 38824 Phone: 662-365-3253 Fax: 662-365-3484 | |