Springridge Medical Clinic | |
507 Springridge Rd Ste A Clinton MS 39056-5628 | |
(601) 708-1414 | |
(601) 708-1415 |
Full Name | Springridge Medical Clinic |
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Speciality | Family Medicine |
Location | 507 Springridge Rd Ste A, Clinton, Mississippi |
Authorized Official Name and Position | Shinita Reed Dudley (DR.) |
Authorized Official Contact | 6012137681 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Springridge Medical Clinic 507 Springridge Rd Ste A Clinton MS 39056-5628 Ph: (601) 708-1414 | Springridge Medical Clinic 507 Springridge Rd Ste A Clinton MS 39056-5628 Ph: (601) 708-1414 |
NPI Number | 1689217978 |
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Provider Enumeration Date | 10/20/2019 |
Last Update Date | 10/25/2022 |
Medicare PECOS PAC ID | 3476980574 |
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Medicare Enrollment ID | O20200303000236 |
Identifier | Type | State | Issuer |
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1689217978 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Shinita Reed Dudley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154354603 PECOS PAC ID: 0547152696 Enrollment ID: I20040325000821 |
Provider Name | Netra B Cooper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679583991 PECOS PAC ID: 0648275198 Enrollment ID: I20060915000550 |
Clinton Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Highway 80 E, Suite D, Clinton, MS 39056 Phone: 318-791-3765 Fax: 877-747-5326 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 498 Highway 80 E, Clinton, MS 39056 Phone: 601-924-4000 | |