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526 Deerfield Dr Suite C Forest MS 39074-6005 | |
(601) 469-0291 | |
(601) 469-0347 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 526 Deerfield Dr, Forest, Mississippi |
Authorized Official Name and Position | Joseph S Mcnulty (OWNER/CEO) |
Authorized Official Contact | 6018496440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1100 Magee MS 39111-1100 Ph: (601) 849-6440 | 526 Deerfield Dr Suite C Forest MS 39074-6005 Ph: (601) 469-0291 |
NPI Number | 1245489186 |
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Provider Enumeration Date | 09/16/2008 |
Last Update Date | 06/22/2015 |
Identifier | Type | State | Issuer |
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1245489186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Forest Family Practice Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Ln, Forest, MS 39074 Phone: 601-469-4861 Fax: 601-469-4828 | |
Independent Healthcare Management, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 516 Airport Rd, Forest, MS 39074 Phone: 601-469-4151 Fax: 601-469-3681 | |