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1002 E Madison St Houston MS 38851-2417 | |
(662) 456-1163 | |
(662) 456-1159 |
Full Name | |
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Speciality | Clinic/center |
Location | 1002 E Madison St, Houston, Mississippi |
Authorized Official Name and Position | Sheila Brockman (CEO) |
Authorized Official Contact | 6624563700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 626 Houston MS 38851-0626 Ph: (662) 456-1163 | 1002 E Madison St Houston MS 38851-2417 Ph: (662) 456-1163 |
NPI Number | 1003096488 |
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Provider Enumeration Date | 11/14/2007 |
Last Update Date | 01/18/2024 |
Identifier | Type | State | Issuer |
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1003096488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 12-296 (Mississippi) | Primary |
Digestive Disease Center Of Houston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 E Madison St, Houston, MS 38851 Phone: 662-456-9203 Fax: 662-456-9206 |