| Julia Street Clinic, Inc. | |
|
102 Julia Street Isola MS 38754 | |
| (662) 962-7923 | |
| Not Available |
| Full Name | Julia Street Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 102 Julia Street, Isola, Mississippi |
| Authorized Official Name and Position | Vernita James (ADMINISTRATOR) |
| Authorized Official Contact | 6629627923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Julia Street Clinic, Inc. Po Box 553 Isola MS 38754-0553 Ph: (662) 962-7923 | Julia Street Clinic, Inc. 102 Julia Street Isola MS 38754 Ph: (662) 962-7923 |
| NPI Number | 1740310549 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740310549 | NPI | - | NPPES |
| 01285834 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
Community Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Julia Street, Isola, MS 38754 Phone: 662-962-7923 Fax: 662-962-2575 |