| Rosedale Family Medical Center, P.c. | |
|
512 Levee St. Rosedale MS 38769-0310 | |
| (662) 759-6806 | |
| (662) 759-6771 |
| Full Name | Rosedale Family Medical Center, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 512 Levee St., Rosedale, Mississippi |
| Authorized Official Name and Position | John William Lewis (PRESIDENT) |
| Authorized Official Contact | 6627596806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosedale Family Medical Center, P.c. P.o.box 310 Rosedale MS 38769-0310 Ph: (662) 759-6806 | Rosedale Family Medical Center, P.c. 512 Levee St. Rosedale MS 38769-0310 Ph: (662) 759-6806 |
| NPI Number | 1043223340 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 04/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043223340 | NPI | - | NPPES |
| 09014540 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 09592 (Mississippi) | Primary |
Bolivar Physician Practices Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 512 Levee St, Rosedale, MS 38769 Phone: 662-759-6806 Fax: 662-759-6771 |