Tyler Holmes Carrollton Clinic | |
504 George Street North Carrollton MS 38947 | |
(662) 989-1574 | |
(662) 989-1569 |
Full Name | Tyler Holmes Carrollton Clinic |
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Speciality | Clinic/Center |
Location | 504 George Street, North Carrollton, Mississippi |
Authorized Official Name and Position | Memorie Lyons (CLINIC DIRECTOR) |
Authorized Official Contact | 6622836119 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tyler Holmes Carrollton Clinic 409 Tyler Holmes Dr Winona MS 38967-1521 Ph: (662) 283-4114 | Tyler Holmes Carrollton Clinic 504 George Street North Carrollton MS 38947 Ph: (662) 989-1574 |
NPI Number | 1548883481 |
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Provider Enumeration Date | 05/27/2020 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 0345142618 |
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Medicare Enrollment ID | O20201117002564 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548883481 | NPI | - | NPPES |
001608351 | Medicaid | MS | |
001709891 | Medicaid | MS | |
1700426707 | Other | MS | NPI |
1497164446 | Other | MS | NPI |
2466404 | Other | MS | WELLCARE |
000015590 | Medicaid | MS | |
200007660 | Medicaid | MS | |
1548883481 | Other | MS | NPI |
1568502714 | Other | MS | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
The Carrollton Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 George St, North Carrollton, MS 38947 Phone: 662-237-4525 Fax: 662-237-9781 |