<unavail> in Petal, MS - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Petal, Mississippi. The current practice location for is 36 Panther Stadium Dr, Petal, Mississippi. For appointments, you can reach them via phone at (601) 450-2144. The mailing address for is Po Box 1729, Hattiesburg, Mississippi and phone number is (601) 545-3700.

is licensed to practice in Mississippi (license number ). The clinic also participates in the medicare program and its NPI number is 1952724650. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (601) 450-2144.

Contact Information


	36 Panther Stadium Dr Petal MS 39465-3632
	(601) 450-2144
	(601) 450-2145

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	36 Panther Stadium Dr, Petal, Mississippi
Authorized Official Name and Position	Kaye Ray (CHEIF EXECUTIVE OFFICER)
Authorized Official Contact	6015458700
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 1729 Hattiesburg MS 39403-1729 Ph: (601) 545-3700	36 Panther Stadium Dr Petal MS 39465-3632 Ph: (601) 450-2144

NPI Details:

NPI Number	1952724650
Provider Enumeration Date	01/31/2014
Last Update Date	09/06/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	2466342605
Medicare Enrollment ID	O20140710000787

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952724650	NPI	-	NPPES
251023	Other	MS	MS MEDICARE PTAN
02622599	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(Mississippi)	Primary

Reviews and Comments

Clinic/Center in Petal, MS

Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1145 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-450-2493
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 W Central Ave, Petal, MS 39465 Phone: 601-296-2552 Fax: 601-296-2397
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 60 Herrington Rd, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-450-2493
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 102 Red Maple Trl, Petal, MS 39465 Phone: 601-606-2554
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9214 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-582-5461
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Pumping Station Rd, Petal, MS 39465 Phone: 601-583-1559 Fax: 601-583-1573

- Medicare Primary Care in Petal, MS