| The Rainbow Children's Clinic | |
|
730 E Fifteenth St Yazoo City MS 39194-2706 | |
| (662) 751-8566 | |
| Not Available |
| Full Name | The Rainbow Children's Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 730 E Fifteenth St, Yazoo City, Mississippi |
| Authorized Official Name and Position | Portia F Travis (NURSE PRACTITIONER) |
| Authorized Official Contact | 6627518566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Rainbow Children's Clinic 730 E Fifteenth St Yazoo City MS 39194-2706 Ph: (662) 751-8566 | The Rainbow Children's Clinic 730 E Fifteenth St Yazoo City MS 39194-2706 Ph: (662) 751-8566 |
| NPI Number | 1033370580 |
|---|---|
| Provider Enumeration Date | 06/18/2008 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033370580 | NPI | - | NPPES |
| 08227546 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R800172 (Mississippi) | Primary |
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