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20 S Sixth St Bay Springs MS 39422-9055 | |
(601) 764-4501 | |
(601) 764-2310 |
Full Name | |
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Speciality | Clinic/Center |
Location | 20 S Sixth St, Bay Springs, Mississippi |
Authorized Official Name and Position | Charlotte Deloach (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6014332998 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 723 Bay Springs MS 39422-9055 Ph: (601) 764-4501 | 20 S Sixth St Bay Springs MS 39422-9055 Ph: (601) 764-4501 |
NPI Number | 1497173942 |
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Provider Enumeration Date | 04/02/2014 |
Last Update Date | 12/18/2024 |
Medicare PECOS PAC ID | 5799902789 |
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Medicare Enrollment ID | O20140815000301 |
Identifier | Type | State | Issuer |
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1497173942 | NPI | - | NPPES |
Provider Name | Mark A Deloach |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679681894 PECOS PAC ID: 4880620566 Enrollment ID: I20050722000525 |
Provider Name | Kenneth M Craven |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750325528 PECOS PAC ID: 9537299680 Enrollment ID: I20100616000255 |
Provider Name | Jessica A Garner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982913729 PECOS PAC ID: 2466635438 Enrollment ID: I20110329000471 |
Provider Name | Leslie A Fisher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811414196 PECOS PAC ID: 0749555621 Enrollment ID: I20171003004592 |
Provider Name | Jakob Wayne Slusher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265047484 PECOS PAC ID: 1153749205 Enrollment ID: I20200922001592 |
Provider Name | Brittany Alane Mccarty |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114689692 PECOS PAC ID: 2567852726 Enrollment ID: I20211201002296 |
Eure-lay Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 433 Highway 18, Bay Springs, MS 39422 Phone: 601-764-2143 Fax: 601-764-4890 | |
Family Health Care Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 298 Hwy 18 West, Bay Springs, MS 39422 Phone: 601-825-7280 Fax: 601-825-8130 |