| Southside Medical Clinic, Llc | |
|
3800 Commerce St Grenada MS 38901 | |
| (662) 230-1161 | |
| Not Available |
| Full Name | Southside Medical Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3800 Commerce St, Grenada, Mississippi |
| Authorized Official Name and Position | Leigh Cain (CREDENTIALING) |
| Authorized Official Contact | 6628097559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical Clinic, Llc 86 Bakers Gate Grenada MS 38901-9775 Ph: (662) 230-1161 | Southside Medical Clinic, Llc 3800 Commerce St Grenada MS 38901 Ph: (662) 230-1161 |
| NPI Number | 1386470367 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386470367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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