| Trace Medical Clinic | |
|
530 Veterans Memorial Dr Kosciusko MS 39090-3858 | |
| (662) 289-9155 | |
| (662) 289-7752 |
| Full Name | Trace Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 530 Veterans Memorial Dr, Kosciusko, Mississippi |
| Authorized Official Name and Position | Edward E Bryant (PRESIDENT/OWNER) |
| Authorized Official Contact | 6622899155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trace Medical Clinic 530 Veterans Memorial Dr Kosciusko MS 39090-3858 Ph: (662) 289-9155 | Trace Medical Clinic 530 Veterans Memorial Dr Kosciusko MS 39090-3858 Ph: (662) 289-9155 |
| NPI Number | 1033383815 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033383815 | NPI | - | NPPES |
| 09016283 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Bmc Attala Kosciusko Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 220 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-4311 Fax: 662-290-3255 | |
Trace Medical Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 662-289-9155 Fax: 662-289-7752 | |
Kosciusko Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 | |
Fast Pace Mississippi, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 931-253-1101 Fax: 931-722-9919 |