| Gorton Clinic | |
|
1401 River Rd Attn Clinic Administration Greenwood MS 38930-4030 | |
| (662) 459-7189 | |
| (662) 459-1147 |
| Full Name | Gorton Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 1401 River Rd, Greenwood, Mississippi |
| Authorized Official Name and Position | Jerry Adams (CEO) |
| Authorized Official Contact | 6624597000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gorton Clinic Po Box 1410 Attn Clinic Administration Greenwood MS 38935-1410 Ph: (662) 459-7189 | Gorton Clinic 1401 River Rd Attn Clinic Administration Greenwood MS 38930-4030 Ph: (662) 459-7189 |
| NPI Number | 1154390854 |
|---|---|
| Provider Enumeration Date | 03/15/2006 |
| Last Update Date | 08/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154390854 | NPI | - | NPPES |
| 09014025 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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