Treesap Clinic, Inc. | |
28301 Highway 15 Walnut MS 38683-9753 | |
(662) 223-0063 | |
(662) 223-0079 |
Full Name | Treesap Clinic, Inc. |
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Speciality | Clinic/center - Primary Care |
Location | 28301 Highway 15, Walnut, Mississippi |
Authorized Official Name and Position | James W. Taylor (OWNER) |
Authorized Official Contact | 6622230063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Treesap Clinic, Inc. 28301 Highway 15 Walnut MS 38683-9753 Ph: (662) 223-0063 | Treesap Clinic, Inc. 28301 Highway 15 Walnut MS 38683-9753 Ph: (662) 223-0063 |
NPI Number | 1861673139 |
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Provider Enumeration Date | 11/15/2007 |
Last Update Date | 11/20/2015 |
Identifier | Type | State | Issuer |
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1861673139 | NPI | - | NPPES |
1265451991 | Other | MS | INDIVIDUAL NPI |
03333061 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | R732656 (Mississippi) | Primary |
Walnut Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 531 Main St, Walnut, MS 38683 Phone: 662-223-4011 Fax: 662-223-4018 |