| |
1001 Holland Ave Suite 4 Philadelphia MS 39350-2161 | |
(601) 656-0010 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 1001 Holland Ave, Philadelphia, Mississippi |
Authorized Official Name and Position | Lawrence Graeber (CEO) |
Authorized Official Contact | 6016631360 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1001 Holland Ave Po Box 976 Philadelphia MS 39350-2161 Ph: (601) 656-0010 | 1001 Holland Ave Suite 4 Philadelphia MS 39350-2161 Ph: (601) 656-0010 |
NPI Number | 1750686341 |
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Provider Enumeration Date | 01/13/2011 |
Last Update Date | 01/13/2011 |
Identifier | Type | State | Issuer |
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1750686341 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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