Winston Medical Clinic Noxapater | |
90 East Main Street Noxapater MS 39346 | |
(662) 724-4051 | |
(662) 724-4054 |
Full Name | Winston Medical Clinic Noxapater |
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Speciality | Clinic/Center |
Location | 90 East Main Street, Noxapater, Mississippi |
Authorized Official Name and Position | Debra J Fryery (DIRECTOR OF CLINIC OPERATIONS) |
Authorized Official Contact | 6624461972 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Winston Medical Clinic Noxapater Po Box 470 Louisville MS 39339-0470 Ph: (662) 446-1972 | Winston Medical Clinic Noxapater 90 East Main Street Noxapater MS 39346 Ph: (662) 724-4051 |
NPI Number | 1588091714 |
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Provider Enumeration Date | 10/02/2013 |
Last Update Date | 02/09/2017 |
Medicare PECOS PAC ID | 7214170968 |
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Medicare Enrollment ID | O20140124001251 |
Identifier | Type | State | Issuer |
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1588091714 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Michael L Ard |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962484899 PECOS PAC ID: 2365523875 Enrollment ID: I20080122000693 |
Provider Name | Heather M Gilmer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477706323 PECOS PAC ID: 3678638509 Enrollment ID: I20090210000264 |