| Vine Medical Associates Llc | |
|
2100 Highway 61 N Vicksburg MS 39183-8211 | |
| (601) 883-5000 | |
| Not Available |
| Full Name | Vine Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 2100 Highway 61 N, Vicksburg, Mississippi |
| Authorized Official Name and Position | Olatunji Oluwatade (CEO) |
| Authorized Official Contact | 6018835000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vine Medical Associates Llc Po Box 1547 Sedalia MO 65302-1547 Ph: (660) 826-5960 | Vine Medical Associates Llc 2100 Highway 61 N Vicksburg MS 39183-8211 Ph: (601) 883-5000 |
| NPI Number | 1497098651 |
|---|---|
| Provider Enumeration Date | 04/05/2013 |
| Last Update Date | 04/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497098651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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