Pontotoc Medical Clinic | |
345 Highway 15 N Pontotoc MS 38863-1105 | |
(662) 489-7430 | |
Not Available |
Full Name | Pontotoc Medical Clinic |
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Speciality | Clinic/Center |
Location | 345 Highway 15 N, Pontotoc, Mississippi |
Authorized Official Name and Position | Joseph A Reppert (CFO) |
Authorized Official Contact | 6623773978 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pontotoc Medical Clinic 176 S Main St Pontotoc MS 38863-3311 Ph: (662) 488-7670 | Pontotoc Medical Clinic 345 Highway 15 N Pontotoc MS 38863-1105 Ph: (662) 489-7430 |
NPI Number | 1538576772 |
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Provider Enumeration Date | 07/21/2014 |
Last Update Date | 09/03/2014 |
Medicare PECOS PAC ID | 6002895356 |
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Medicare Enrollment ID | O20141013000785 |
Identifier | Type | State | Issuer |
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1538576772 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 16091 (Mississippi) | Primary |
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Mississippicare 113 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 353 Highway 15 N, Pontotoc, MS 38863 Phone: 662-490-1985 Fax: 662-490-1989 |