| Brookhaven Medical Center, Pllc | |
|
218 S Victoria Ave Cleveland MS 38732-3234 | |
| (901) 217-3480 | |
| Not Available |
| Full Name | Brookhaven Medical Center, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 218 S Victoria Ave, Cleveland, Mississippi |
| Authorized Official Name and Position | Deborah Michelle Brooks (C.E.O.) |
| Authorized Official Contact | 9012173480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookhaven Medical Center, Pllc 218 S Victoria Ave Cleveland MS 38732-3234 Ph: (901) 217-3480 | Brookhaven Medical Center, Pllc 218 S Victoria Ave Cleveland MS 38732-3234 Ph: (901) 217-3480 |
| NPI Number | 1821033341 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 07/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821033341 | NPI | - | NPPES |
| 00124352 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 17310 (Mississippi) | Primary |
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