| Baptist Medical Center-leake, Inc | |
|
17509 Highway 21 Walnut Grove MS 39189-6505 | |
| (601) 267-1320 | |
| Not Available |
| Full Name | Baptist Medical Center-leake, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17509 Highway 21, Walnut Grove, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Medical Center-leake, Inc 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (601) 267-1320 | Baptist Medical Center-leake, Inc 17509 Highway 21 Walnut Grove MS 39189-6505 Ph: (601) 267-1320 |
| NPI Number | 1649546342 |
|---|---|
| Provider Enumeration Date | 03/27/2012 |
| Last Update Date | 10/15/2025 |
| Medicare PECOS PAC ID | 7214102961 |
|---|---|
| Medicare Enrollment ID | O20140225001687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649546342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
East Central Mississippi Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 199 Rimmer St, Walnut Grove, MS 39189 Phone: 601-253-2733 Fax: 601-253-2733 | |
Neshoba County General Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Park St, Walnut Grove, MS 39189 Phone: 601-253-0173 Fax: 601-253-0176 | |
Baptist Medical Center-leake, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Park St, Walnut Grove, MS 39189 Phone: 601-267-1400 |