| Brookhaven Internal Medicine, P.A. | |
|
527 Silver Cross Dr Brookhaven MS 39601-2388 | |
| (601) 835-0507 | |
| (601) 835-2766 |
| Full Name | Brookhaven Internal Medicine, P.A. |
|---|---|
| Speciality | Internal Medicine |
| Location | 527 Silver Cross Dr, Brookhaven, Mississippi |
| Authorized Official Name and Position | Diane M Price (OFFICE MANAGER) |
| Authorized Official Contact | 6018350507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookhaven Internal Medicine, P.A. Po Box 3730 Brookhaven MS 39603-7730 Ph: (601) 835-0507 | Brookhaven Internal Medicine, P.A. 527 Silver Cross Dr Brookhaven MS 39601-2388 Ph: (601) 835-0507 |
| NPI Number | 1699884528 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810030319 |
|---|---|
| Medicare Enrollment ID | O20100205000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699884528 | NPI | - | NPPES |
| 09014373 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Bryan S. Calcote |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073622999 PECOS PAC ID: 6800939307 Enrollment ID: I20100826000804 |
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