| Careone Medical Clinic | |
|
14 Northtown Dr Ste 105 Jackson MS 39211-3018 | |
| (601) 397-4079 | |
| Not Available |
| Full Name | Careone Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 14 Northtown Dr Ste 105, Jackson, Mississippi |
| Authorized Official Name and Position | Tye Rollins (CFO, CLINICAL DIRECTOR) |
| Authorized Official Contact | 6013974079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Careone Medical Clinic 14 Northtown Dr Ste 105 Jackson MS 39211-3018 Ph: (601) 397-4079 | Careone Medical Clinic 14 Northtown Dr Ste 105 Jackson MS 39211-3018 Ph: (601) 397-4079 |
| NPI Number | 1114427507 |
|---|---|
| Provider Enumeration Date | 02/13/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114427507 | NPI | - | NPPES |
| 00855040 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (NU) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (NU) | Secondary |
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