| Avalon Medical LLC | |
|
1413 W Quitman St Iuka MS 38852-1130 | |
| (662) 424-9550 | |
| Not Available |
| Full Name | Avalon Medical LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1413 W Quitman St, Iuka, Mississippi |
| Authorized Official Name and Position | Tommy Draper (MEMBER) |
| Authorized Official Contact | 6624249550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Medical LLC 1413 W Quitman St Iuka MS 38852-1130 Ph: (662) 424-9550 | Avalon Medical LLC 1413 W Quitman St Iuka MS 38852-1130 Ph: (662) 424-9550 |
| NPI Number | 1710216346 |
|---|---|
| Provider Enumeration Date | 12/10/2009 |
| Last Update Date | 10/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710216346 | NPI | - | NPPES |
| 04352560 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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