Full Name | |
---|---|
Speciality | General Practice |
Location | 934 West Dr, Laurel, Mississippi |
Authorized Official Name and Position | Jerry Mayo (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6015444641 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 18679 Hattiesburg MS 39404-8679 Ph: (601) 705-1902 | 934 West Dr Laurel MS 39440-4702 Ph: (601) 426-7520 |
NPI Number | 1467767988 |
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Provider Enumeration Date | 08/09/2010 |
Last Update Date | 08/09/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467767988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-428-6561 | |
Jefferson Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 | |