Okolona Physician Office | |
119 Robertson St Okolona MS 38860-1620 | |
(662) 447-3882 | |
(662) 447-2265 |
Full Name | Okolona Physician Office |
---|---|
Speciality | Family Medicine |
Location | 119 Robertson St, Okolona, Mississippi |
Authorized Official Name and Position | Gerald Kimbrough (MANAGER) |
Authorized Official Contact | 6623774685 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Okolona Physician Office 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | Okolona Physician Office 119 Robertson St Okolona MS 38860-1620 Ph: (662) 447-3882 |
NPI Number | 1083724009 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083724009 | NPI | - | NPPES |
09013699 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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