| Chickasaw Medical Clinic | |
|
208 Country Club Rd Houston MS 38851-9326 | |
| (662) 456-3437 | |
| (662) 456-2070 |
| Full Name | Chickasaw Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 208 Country Club Rd, Houston, Mississippi |
| Authorized Official Name and Position | Gerald Kimbrough (MANAGER) |
| Authorized Official Contact | 6623774685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chickasaw Medical Clinic 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | Chickasaw Medical Clinic 208 Country Club Rd Houston MS 38851-9326 Ph: (662) 456-3437 |
| NPI Number | 1710097134 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710097134 | NPI | - | NPPES |
| 09013750 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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