| Tri-lakes Pediatric Clinic | |
|
435 Highway 6 E Batesville MS 38606-3001 | |
| (662) 563-7873 | |
| (662) 563-8129 |
| Full Name | Tri-lakes Pediatric Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 435 Highway 6 E, Batesville, Mississippi |
| Authorized Official Name and Position | Laurie Holtsford (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6154657466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-lakes Pediatric Clinic Po Box 731804 Dallas TX 75373-1084 Ph: (662) 563-5611 | Tri-lakes Pediatric Clinic 435 Highway 6 E Batesville MS 38606-3001 Ph: (662) 563-7873 |
| NPI Number | 1851624795 |
|---|---|
| Provider Enumeration Date | 09/10/2009 |
| Last Update Date | 08/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851624795 | NPI | - | NPPES |
| 09013323 | Medicaid | MS | |
| 09409733 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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