| Prime Urgent Medical Clinic | |
|
176 Goodman Rd W Southaven MS 38671-9405 | |
| (662) 536-1020 | |
| Not Available |
| Full Name | Prime Urgent Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 176 Goodman Rd W, Southaven, Mississippi |
| Authorized Official Name and Position | Achin Sharma (PHYSICIAN) |
| Authorized Official Contact | 6625361020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Urgent Medical Clinic 176 Goodman Rd W Southaven MS 38671-9405 Ph: (662) 536-1020 | Prime Urgent Medical Clinic 176 Goodman Rd W Southaven MS 38671-9405 Ph: (662) 536-1020 |
| NPI Number | 1578613188 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 03/19/2015 |
| Medicare PECOS PAC ID | 9739288937 |
|---|---|
| Medicare Enrollment ID | O20070629000221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578613188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15476 (Mississippi) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Secondary |
| Provider Name | Achin Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093715641 PECOS PAC ID: 8527097203 Enrollment ID: I20070629000246 |
| Provider Name | Vanessa A Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104879329 PECOS PAC ID: 4385719467 Enrollment ID: I20080825000453 |
| Provider Name | Elizabeth R Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316143282 PECOS PAC ID: 1557255718 Enrollment ID: I20081013000398 |
| Provider Name | Sabra F Drake |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346257771 PECOS PAC ID: 6305814286 Enrollment ID: I20100728000413 |
| Provider Name | Naseem D Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023427481 PECOS PAC ID: 3274754932 Enrollment ID: I20200826001468 |
| Provider Name | Lauren R Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912552100 PECOS PAC ID: 6305264151 Enrollment ID: I20201230001201 |
| Provider Name | Tatyana Dromova Pasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164056693 PECOS PAC ID: 8527467398 Enrollment ID: I20210927001061 |
| Provider Name | Leeza Turri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366195737 PECOS PAC ID: 2163804857 Enrollment ID: I20220727002327 |
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