| Pas-point Family Clinic, Llc | |
|
3736 Main St Moss Point MS 39563-5108 | |
| (228) 474-2242 | |
| (228) 475-6271 |
| Full Name | Pas-point Family Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3736 Main St, Moss Point, Mississippi |
| Authorized Official Name and Position | Dunk A Ellis (OWNER) |
| Authorized Official Contact | 2284742212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pas-point Family Clinic, Llc 3736 Main St P.o. Box 8572 Moss Point MS 39563-5108 Ph: (228) 474-2242 | Pas-point Family Clinic, Llc 3736 Main St Moss Point MS 39563-5108 Ph: (228) 474-2242 |
| NPI Number | 1639621675 |
|---|---|
| Provider Enumeration Date | 10/25/2016 |
| Last Update Date | 02/01/2022 |
| Medicare PECOS PAC ID | 0941671234 |
|---|---|
| Medicare Enrollment ID | O20230124003081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639621675 | NPI | - | NPPES |
| 00113221 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 17210 (Mississippi) | Secondary |
| Provider Name | Dunk A Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043342322 PECOS PAC ID: 2769450204 Enrollment ID: I20040922000361 |
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