| |
1014 Rose Street Prentiss MS 39474 | |
(601) 792-2071 | |
(601) 792-8134 |
Full Name | |
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Speciality | Family Medicine |
Location | 1014 Rose Street, Prentiss, Mississippi |
Authorized Official Name and Position | Bryan N Batson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6012685601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 579-5463 | 1014 Rose Street Prentiss MS 39474 Ph: (601) 792-2071 |
NPI Number | 1215023122 |
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Provider Enumeration Date | 10/05/2006 |
Last Update Date | 10/07/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215023122 | NPI | - | NPPES |
09014320 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 910 Second Street, Prentiss, MS 39474 Phone: 601-792-2078 Fax: 601-792-8211 | |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 J E Johnson Rd, Prentiss, MS 39474 Phone: 601-825-7280 Fax: 601-825-8130 | |
Ware Family Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 972 Columbia Ave, Prentiss, MS 39474 Phone: 601-792-5343 |