| The Carrollton Clinic | |
|
502 George St North Carrollton MS 38947-0220 | |
| (662) 237-4525 | |
| (662) 237-9781 |
| Full Name | The Carrollton Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 502 George St, North Carrollton, Mississippi |
| Authorized Official Name and Position | Susan Jenay Neely (PHYSICIAN) |
| Authorized Official Contact | 6622374525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Carrollton Clinic Po Box 220 North Carrollton MS 38947-0220 Ph: (662) 237-4525 | The Carrollton Clinic 502 George St North Carrollton MS 38947-0220 Ph: (662) 237-4525 |
| NPI Number | 1558588509 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 08/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558588509 | NPI | - | NPPES |
| 01588099 | Medicaid | MS | |
| 00121561 | Medicaid | MS | |
| 426493934A | Other | MS | BLUE CROSS BLUE SHIELD |
| P00228400 | Other | MS | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Tyler Holmes Carrollton Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 504 George Street, North Carrollton, MS 38947 Phone: 662-989-1574 Fax: 662-989-1569 |