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1002 E Madison St Ste 2 Houston MS 38851-2428 | |
(662) 456-5008 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1002 E Madison St Ste 2, Houston, Mississippi |
Authorized Official Name and Position | Robert Quentin Whitwell (CEO) |
Authorized Official Contact | 6627019346 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 432 Houston MS 38851-0432 Ph: (662) 456-5008 | 1002 E Madison St Ste 2 Houston MS 38851-2428 Ph: (662) 456-5008 |
NPI Number | 1902663388 |
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Provider Enumeration Date | 03/04/2024 |
Last Update Date | 07/26/2024 |
Medicare PECOS PAC ID | 0143662429 |
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Medicare Enrollment ID | O20240604003318 |
Identifier | Type | State | Issuer |
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1902663388 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Digestive Disease Center Of Houston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 E Madison St, Houston, MS 38851 Phone: 662-456-9203 Fax: 662-456-9206 |