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5062 Raymond Ave Tupelo MS 38801-8671 | |
(662) 566-5593 | |
(662) 566-4419 |
Full Name | |
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Speciality | Family Medicine |
Location | 5062 Raymond Ave, Tupelo, Mississippi |
Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
Authorized Official Contact | 6623772774 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-2386 | 5062 Raymond Ave Tupelo MS 38801-8671 Ph: (662) 566-5593 |
NPI Number | 1306235270 |
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Provider Enumeration Date | 01/15/2015 |
Last Update Date | 01/21/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306235270 | NPI | - | NPPES |
008020835 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-2386 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |