| Eudora Medical Clinic | |
|
8995 W Commerce St Ste 4 Hernando MS 38632-6812 | |
| (662) 589-6290 | |
| (662) 649-6085 |
| Full Name | Eudora Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 8995 W Commerce St Ste 4, Hernando, Mississippi |
| Authorized Official Name and Position | Amy M. Perkins (OWNER) |
| Authorized Official Contact | 6625896290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eudora Medical Clinic 8995 W Commerce St Ste 4 Hernando MS 38632-6812 Ph: (662) 589-6290 | Eudora Medical Clinic 8995 W Commerce St Ste 4 Hernando MS 38632-6812 Ph: (662) 589-6290 |
| NPI Number | 1255043493 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/06/2023 |
| Medicare PECOS PAC ID | 8123490166 |
|---|---|
| Medicare Enrollment ID | O20230221000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255043493 | NPI | - | NPPES |
| 03003882 | Medicaid | MS | |
| 879057 | Other | MS | MS NURSING/NP LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | () | Primary |
| Provider Name | Amy M Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487903936 PECOS PAC ID: 7113176769 Enrollment ID: I20120926000060 |
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