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22741 Highway 12 Lexington MS 39095-3118 | |
(662) 834-1961 | |
(662) 834-1962 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 22741 Highway 12, Lexington, Mississippi |
Authorized Official Name and Position | Paula Lang (CEO) |
Authorized Official Contact | 6622473831 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 510 Belzoni MS 39038-0510 Ph: (662) 247-3831 | 22741 Highway 12 Lexington MS 39095-3118 Ph: (662) 834-1961 |
NPI Number | 1013213222 |
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Provider Enumeration Date | 02/04/2011 |
Last Update Date | 02/08/2011 |
Identifier | Type | State | Issuer |
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1013213222 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mallory Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |