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MISSISSIPPI MEDICAL CLINIC 1114694536

Overview
Name: MISSISSIPPI MEDICAL CLINIC Specialty: Family Nurse Practitioner Type of Practice: Organization Provider/Org: Medical School: Graduation year from medical school: Affiliation:
Specialties
Practice Type: Physician Assistants & Advanced Practice Nursing Providers Classification: Nurse Practitioner Specialization: Family. Definition of Specialty: Definition to come…
License & NPI
License #(s): , , , , License State(s): , , , ,
Addresses
Practice Location: MISSISSIPPI MEDICAL CLINIC,403 PINE ST,TAYLORSVILLE,MS,391685659,US Mailing Address: MISSISSIPPI MEDICAL CLINIC,403 PINE ST,TAYLORSVILLE,MS,391685659,US
Contact #
Practice location phone #: 6014527080 Practice location fax #: 6014527083 Mailing address Phone #: 6014527080 Mailing Address fax #: 6014527083 Authorized official Name/Telephone #:MRS., PATTY, BULLOCK, NP, NP MANAGING PARTNER 6014527080
Misc
Date NPI was obtained: 08/24/2021 Last data data was updated: 12/02/2021 Insurances:

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