| |
1220 Jefferson St Laurel MS 39440-4355 | |
(601) 426-4739 | |
(601) 426-4739 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 1220 Jefferson St, Laurel, Mississippi |
Authorized Official Name and Position | James T Canizaro (ASSOCIATE EXEC. DIRECTOR/CFO) |
Authorized Official Contact | 6013996139 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 246 Laurel MS 39441-0246 Ph: (601) 426-4739 | 1220 Jefferson St Laurel MS 39440-4355 Ph: (601) 426-4739 |
NPI Number | 1063742658 |
---|---|
Provider Enumeration Date | 01/05/2010 |
Last Update Date | 01/05/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063742658 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-428-6561 | |
Jefferson Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 | |