| Professional Association Corporation | |
|
1307 East Union Greenville MS 38703 | |
| (662) 335-3541 | |
| Not Available |
| Full Name | Professional Association Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1307 East Union, Greenville, Mississippi |
| Authorized Official Name and Position | Michael Joseph Cirilli (SEC TRES DRS LENOIR AND CIRILLI PA) |
| Authorized Official Contact | 6623353541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Association Corporation Po Box 5967 1307 East Union Greenville MS 38704-5967 Ph: (662) 335-3541 | Professional Association Corporation 1307 East Union Greenville MS 38703 Ph: (662) 335-3541 |
| NPI Number | 1346462751 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 07/15/2008 |
| Medicare PECOS PAC ID | 8123208394 |
|---|---|
| Medicare Enrollment ID | O20110204000216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346462751 | NPI | - | NPPES |
| 9011164 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10254 (Mississippi) | Secondary |
| 207R00000X | Internal Medicine | 3813 (Mississippi) | Primary |
| 207R00000X | Internal Medicine | 10254 (Mississippi) | Secondary |
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