Gale Primary Care, Llc | |
3702 Jefferson Ave Moss Point MS 39563-6218 | |
(228) 641-1674 | |
(228) 205-4593 |
Full Name | Gale Primary Care, Llc |
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Speciality | Clinic/Center |
Location | 3702 Jefferson Ave, Moss Point, Mississippi |
Authorized Official Name and Position | Tammy Gale (OWNER) |
Authorized Official Contact | 2286411674 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gale Primary Care, Llc 3702 Jefferson Ave Moss Point MS 39563-6218 Ph: (228) 641-1674 | Gale Primary Care, Llc 3702 Jefferson Ave Moss Point MS 39563-6218 Ph: (228) 641-1674 |
NPI Number | 1083424857 |
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Provider Enumeration Date | 01/13/2025 |
Last Update Date | 01/15/2025 |
Medicare PECOS PAC ID | 9133658180 |
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Medicare Enrollment ID | O20250121002679 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083424857 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Tammy Jo Gale |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730821851 PECOS PAC ID: 6901259696 Enrollment ID: I20250121002756 |
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