Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1430 Jefferson St, Laurel, Mississippi |
Authorized Official Name and Position | Monica Morrow (DIRECTOR CLINIC SUPPORT) |
Authorized Official Contact | 6014257550 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 247 Laurel MS 39441-0247 Ph: (601) 425-7550 | 1430 Jefferson St Laurel MS 39440 Ph: (601) 425-2273 |
NPI Number | 1669609111 |
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Provider Enumeration Date | 06/11/2009 |
Last Update Date | 09/29/2022 |
Medicare PECOS PAC ID | 4385876655 |
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Medicare Enrollment ID | O20140822001818 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669609111 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (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 | |