| |
806 Earl Frye Blvd Amory MS 38821-5505 | |
(662) 478-2450 | |
(662) 534-2330 |
Full Name | |
---|---|
Speciality | Nurse Practitioner |
Location | 806 Earl Frye Blvd, Amory, Mississippi |
Authorized Official Name and Position | Jennifer C Bullock (PRESIDENT) |
Authorized Official Contact | 6625342227 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
206 Oxford Rd New Albany MS 38652-3115 Ph: (662) 534-2227 | 806 Earl Frye Blvd Amory MS 38821-5505 Ph: (662) 478-2450 |
NPI Number | 1578189973 |
---|---|
Provider Enumeration Date | 06/22/2020 |
Last Update Date | 10/05/2023 |
Medicare PECOS PAC ID | 1951724392 |
---|---|
Medicare Enrollment ID | O20200914001414 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578189973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Access Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 2nd Ave N, Amory, MS 38821 Phone: 662-256-5658 Fax: 662-651-4687 | |
Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Gilmore Dr, Amory, MS 38821 Phone: 662-256-3564 Fax: 662-256-3996 | |