| Fondren Medical Clinic | |
|
4436 N State St Suite A-1 Jackson MS 39206-5334 | |
| (769) 257-5339 | |
| Not Available |
| Full Name | Fondren Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4436 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Theresa Leijuan Lane-fisher (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7692575336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fondren Medical Clinic 4436 N State St Suite A-1 Jackson MS 39206-5334 Ph: (769) 257-5339 | Fondren Medical Clinic 4436 N State St Suite A-1 Jackson MS 39206-5334 Ph: (769) 257-5339 |
| NPI Number | 1043573199 |
|---|---|
| Provider Enumeration Date | 06/22/2012 |
| Last Update Date | 06/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043573199 | NPI | - | NPPES |
| 00125523 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |