| Urgent & Primary Care Of Clarksdale Llc | |
|
125 Highway 322 Clarksdale MS 38614-4620 | |
| (662) 313-3269 | |
| Not Available |
| Full Name | Urgent & Primary Care Of Clarksdale Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 125 Highway 322, Clarksdale, Mississippi |
| Authorized Official Name and Position | Mary Williams (OWNER/PROVIDER) |
| Authorized Official Contact | 6623511970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urgent & Primary Care Of Clarksdale Llc Po Box 2098 Clarksdale MS 38614-8098 Ph: () - | Urgent & Primary Care Of Clarksdale Llc 125 Highway 322 Clarksdale MS 38614-4620 Ph: (662) 313-3269 |
| NPI Number | 1013444058 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 04/23/2018 |
| Medicare PECOS PAC ID | 4486917721 |
|---|---|
| Medicare Enrollment ID | O20180418002842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013444058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Mississippi) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Mary A Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184806150 PECOS PAC ID: 2466362439 Enrollment ID: I20100226000232 |
| Provider Name | Kristalin Y Presley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841817707 PECOS PAC ID: 1153747811 Enrollment ID: I20200812003012 |
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