| Truemed Clinic Llc | |
|
8727 Northwest Dr Ste B Southaven MS 38671-2429 | |
| (662) 536-6209 | |
| (662) 342-9922 |
| Full Name | Truemed Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8727 Northwest Dr Ste B, Southaven, Mississippi |
| Authorized Official Name and Position | Jeffrey B King (MANAGING MEMBER) |
| Authorized Official Contact | 9014899212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Truemed Clinic Llc Po Box 624 Southaven MS 38671-0007 Ph: (901) 489-9212 | Truemed Clinic Llc 8727 Northwest Dr Ste B Southaven MS 38671-2429 Ph: (662) 536-6209 |
| NPI Number | 1851049159 |
|---|---|
| Provider Enumeration Date | 03/15/2022 |
| Last Update Date | 03/15/2022 |
| Medicare PECOS PAC ID | 1153704242 |
|---|---|
| Medicare Enrollment ID | O20220823001885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851049159 | NPI | - | NPPES |
| Provider Name | Charla F Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225027832 PECOS PAC ID: 8123096633 Enrollment ID: I20060602000177 |
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