| Elite Medical, PLLC | |
|
2633 Traceland Dr Tupelo MS 38801-4238 | |
| (662) 205-4652 | |
| (662) 205-4651 |
| Full Name | Elite Medical, PLLC |
|---|---|
| Speciality | Clinic/center |
| Location | 2633 Traceland Dr, Tupelo, Mississippi |
| Authorized Official Name and Position | Anne Dye Haire (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6622054652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical, PLLC Po Box 2484 Tupelo MS 38803-2484 Ph: (662) 205-4652 | Elite Medical, PLLC 2633 Traceland Dr Tupelo MS 38801-4238 Ph: (662) 205-4652 |
| NPI Number | 1871887661 |
|---|---|
| Provider Enumeration Date | 06/08/2011 |
| Last Update Date | 10/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871887661 | NPI | - | NPPES |
| 00126275 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 16935 (Mississippi) | Primary |
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