| Port Gibson Middle School | |
|
161 Ramsey Dr Port Gibson MS 39150-2531 | |
| (601) 437-4251 | |
| Not Available |
| Full Name | Port Gibson Middle School |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 161 Ramsey Dr, Port Gibson, Mississippi |
| Authorized Official Name and Position | Annie Kilcrease (SUPERINTENDENT OF EDUCATION) |
| Authorized Official Contact | 6014374232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Gibson Middle School 404 Market St Port Gibson MS 39150-2025 Ph: (601) 437-4232 | Port Gibson Middle School 161 Ramsey Dr Port Gibson MS 39150-2531 Ph: (601) 437-4251 |
| NPI Number | 1164757142 |
|---|---|
| Provider Enumeration Date | 10/09/2009 |
| Last Update Date | 10/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164757142 | NPI | - | NPPES |
| 02382394 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 02382394 (Mississippi) | Primary |
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Family Wellness Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 703b Farmer St, Port Gibson, MS 39150 Phone: 601-437-5668 Fax: 601-437-4533 | |
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