| Pediatric & Adolescent Clinic | |
|
308 Highland Blvd Natchez MS 39120-4611 | |
| (601) 442-7676 | |
| Not Available |
| Full Name | Pediatric & Adolescent Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 308 Highland Blvd, Natchez, Mississippi |
| Authorized Official Name and Position | David Alan Timm (OWNER) |
| Authorized Official Contact | 6014427676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric & Adolescent Clinic 308 Highland Blvd Natchez MS 39120-4611 Ph: (601) 442-7676 | Pediatric & Adolescent Clinic 308 Highland Blvd Natchez MS 39120-4611 Ph: (601) 442-7676 |
| NPI Number | 1366890238 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 05/10/2021 |
| Medicare PECOS PAC ID | 3870788722 |
|---|---|
| Medicare Enrollment ID | O20170112002400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366890238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Mississippi) | Primary |
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