| Prentiss Family Practice Clinic | |
|
1014 Rose Street Prentiss MS 39474 | |
| (601) 792-2071 | |
| (601) 792-8134 |
| Full Name | Prentiss Family Practice Clinic |
|---|---|
| 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 |
|---|---|
| Prentiss Family Practice Clinic 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 579-5463 | Prentiss Family Practice Clinic 1014 Rose Street Prentiss MS 39474 Ph: (601) 792-2071 |
| NPI Number | 1215023122 |
|---|---|
| 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 |
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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 | |
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